Endoscopic Hemoclip versus Triclip Placement in Patients With High-Risk Peptic Ulcer Bleeding

Hwai-Jeng Lin; Wen-Ching Lo; Yang-Chih Cheng; Chin-Lin Perng
March 2007
American Journal of Gastroenterology;Mar2007, Vol. 102 Issue 3, p539
Academic Journal
BACKGROUND: Hemoclip placement is an effective endoscopic therapy for peptic ulcer bleeding. Triclip is a novel clipping device with three prongs over the distal end. So far, there is no clinical study concerning the hemostatic effect of triclip placement. AIM: To determine the hemostatic effect of the triclip as compared with that of the hemoclip. METHODS: A total of 100 peptic ulcer patients with active bleeding or nonbleeding visible vessels received endoscopic therapy with either hemoclip (N = 50) or triclip placement (N = 50). After obtaining initial hemostasis, they received omeprazole 40 mg intravenous infusion every 12 h for 3 days. The main outcome assessment was hemostatic rate and rebleeding rate at 14 days. RESULTS: Initial hemostasis was obtained in 47 patients (94%) of the hemoclip group and in 38 patients (76%) of the triclip group ( P= 0.011). Rebleeding episodes, volume of blood transfusion, the hospital stay, numbers of patients requiring urgent operation, and mortality were not statistically different between the two groups. CONCLUSION: Hemoclip is superior to triclip in obtaining primary hemostasis in patients with high-risk peptic ulcer bleeding. In bleeders located over difficult-to-approach sites, hemoclip is more ideal than triclip.


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