Endoscopic Vacuum Therapy for the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Valuable Resource for the Endoscopist’s Toolbox

Background and study aims: Endoscopic Vacuum Therapy (EVT) is a well-established method for managing gastrointestinal perforations. During the COVID epidemic, case reports demonstrated the effective use of EVT in controlling COVID related diffuse duodenal bleeding. Due to its unique mechanism of action, this approach may also be effective for other types of Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB). This study aims to assess EVT in the treatment of NVUGIB. Patients and methods: This retrospective analysis of a prospectively collected database includes patients who underwent EVT for the treatment of NVUGIB. The primary outcome was clinical success. Secondary outcomes included technical success and safety. Subgroup analysis comparing outcomes for patients with and without COVID was conducted. Results: A total of 19 patients underwent EVT for NVUGIB, with 57.9% having failed other therapies. Technical success occurred in all patients, and clinical success was achieved in 89.5%. There was no difference in clinical success rates between patients with or without COVID (88% versus 91%, respectively). No procedure-related adverse events occurred. Conclusion: EVT appears to be safe and effective in the management of NVUGIB. This approach could be particularly useful in refractory or diffuse bleeding. Larger studies are warranted to validate these findings.

Publication History

Received: 26 August 2024

Accepted after revision: 21 February 2025

Accepted Manuscript online:
21 February 2025