Prophylactic Hemoclip Placement: is it Really Necessary?

Aims The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB.

Methods we conducted a retrospective study including patients with polyps 5 to 20 mm in size underwent cold snare polypectomy (CSP), cold snare endoscopic mucosal resection (CS-EMR) or endoscopic mucosal resection (EMR) from 2016 to 2020. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group. The incidence of delayed PPB was compared between the groups. This study excluded the per polypectomy bleeding.

Results A total of 54 patients were included aging from 22 to 80 year old, involving 76 polypectomies. Thirty five (46 %) polyps were in the clipping group and 41 (53.9 %) polyps were in the non-clipping group. Only one patient had presented a PPB. She was 71 years-old and was under oral anticoagulants. This patient polyp size was 7 mm and was sessile. There were no significant differences in the incidence of delayed PPB between two groups (p=0.23).

Conclusions Prophylactic use of modern hemoclip technology is generally recommended, particularly in patients at high risk that have undergone removal of large sessile polyps or if treated with anticoagulant drugs. In our study, polyps sized 5 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Determining the true cost-effectiveness of treatment, particularly for reducing risk for a relatively rare event, may require much more data than are currently available.

Citation: Kefi M, Bouchabou B, Laabidi S et al. eP220 PROPHYLACTIC HEMOCLIP PLACEMENT: IS IT REALLY NECESSARY? Endoscopy 2021; 53: S170.

Publication History

Article published online:
19 March 2021