Comparison of hemostasis using bipolar hemostatic forceps with hemostasis by endoscopic hemoclipping for nonvariceal upper gastrointestinal bleeding in a prospective non-randomized trial
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We previously reported on the safety and efficacy of bipolar hemostatic forceps for treating nonvariceal upper gastrointestinal (UGI) bleeding. However, no prospective or randomized studies have evaluated the efficacy of bipolar hemostatic forceps. The aim of this study was to evaluate the hemostatic efficacy of using bipolar hemostatic forceps compared with the hemostatic efficacy of the commonly used method of endoscopic hemoclipping for treating nonvariceal UGI bleeding.
A total of 50 patients who required endoscopic hemostasis for UGI bleeding were divided into two groups: those who underwent endoscopic hemostasis using bipolar hemostatic forceps (Group I) and those who underwent endoscopic hemostasis by endoscopic hemoclipping (Group II). We compared the two groups in terms of hemostasis success rate and time required to achieve hemostasis and stop recurrent bleeding.
All (100 %) of 27 patients in Group I and 18 (78.2 %) of 23 patients in Group II were successfully treated using bipolar hemostatic forceps or by endoscopic hemoclipping alone, respectively, indicating a significantly higher success rate for Group I than for Group II (p < 0.05). The time required to achieve hemostasis was 6.8 ± 13.4 min for Group I and 15.4 ± 17.0 min for Group II. One patient in Group I (3.7 %) and four patients in Group II (22.2 %) experienced recurrent bleeding.
Bipolar hemostatic forceps was more effective than endoscopic hemoclipping for treating nonvariceal UGI bleeding.
KeywordsBipolar forceps Gastrointestinal ulcers Endoscopy Hemostasis
This study was supported by a Grant from Tokyo Medical University. We are also indebted to Mr. Roderick J. Turner, Associate Professor Edward F. Barroga, and Professor J. Patrick Barron, Chairman of the Department of International Medical Communications at Tokyo Medical University, for their editorial review of the English manuscript.
Drs. Mikinori Kataoka, Takashi Kawai, Yasutaka Hayama, Kei Yamamoto, Masaya Nonaka, Takaya Aoki, Kenji Yagi, Mari Fukuzawa, Masakatsu Fukuzawa, and Fuminori Moriyasu have no conflicts of interest or financial ties to disclose.
Video: Case presentation: Hemorrhagic gastric ulcer of the antrum along the lesser curvature. (WMV 3450 kb)
Video: Case presentation: Hemostasis by coagulation was achieved through application of electricity with the bipolar forceps kept open and compressed, without causing dislocation. (WMV 4935 kb)
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