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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(10): E1190-E1195
DOI: 10.1055/a-2420-2419
Innovation forum

Effectiveness and safety of a new clip for delivery using a duodenoscope for bleeding after endoscopic sphincterotomy

Atsushi Yamaguchi 
1   Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan (Ringgold ID: RIN37086)
,
Hiroki Kamada
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Shigeaki Semba
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Naohiro Kato
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Yasuhiro Okuda
1   Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan (Ringgold ID: RIN37086)
3   Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan (Ringgold ID: RIN68272)
,
Yuji Teraoka
1   Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan (Ringgold ID: RIN37086)
,
Takeshi Mizumoto
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Yuzuru Tamaru
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Tsuyoshi Hatakeyama
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
,
Hirotaka Kouno
1   Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan (Ringgold ID: RIN37086)
,
Shigeto Yoshida
2   Endoscopy, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
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Abstract

Background and study aims Hemostasis for post-endoscopic sphincterotomy (post-EST) bleeding involves no standard strategy. New clips designed for delivery using the duodenoscope (SureClip, Micro-Tech, Nanjing, China) have been utilized for gastrointestinal bleeding hemostasis and bleeding prevention after polypectomy and papillectomy. We retrospectively analyzed the effectiveness and safety of SureClip for post-EST bleeding.

Patients and methods Of 608 patients with endoscopic sphincterotomy (EST), 41 cases (6.7%) experienced post-EST bleeding from 2019 to 2023. Of these patients, 24 underwent hemostasis by SureClip, and the success rate of complete hemostasis and complication by hemostasis by SureClip was analyzed.

Results In 12 and 12 patients with urgent and delayed bleeding, 11 (91.7%) and 11 (91.7%) had successful hemostasis, respectively. In addition, missed patients achieved complete hemostasis with additional transcatheter arterial embolization and balloon compression, respectively. No complications were observed, including perforation, pancreatitis, and clipping bile duct and pancreatic duct by mistake.

Conclusions Hemostasis with SureClip is safe, effective, and not expensive for post-EST bleeding. It could be the first choice for hemostasis in patients with post-EST bleeding refractory to balloon compression.

Keywords

Pancreatobiliary (ERCP/PTCD) - Stones - ERC topics - Strictures

Supplementary Material



Publikationsverlauf

Eingereicht: 03. Juli 2024

Angenommen nach Revision: 06. September 2024

Accepted Manuscript online:
23. September 2024

Artikel online veröffentlicht:
15. Oktober 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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