Clin Endosc.  2022 May;55(3):339-346. 10.5946/ce.2021.249.

Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment

Affiliations
  • 1Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Napoli, Italy
  • 2Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Roma, Italy
  • 3Gastroenterology and Digestive Endoscopy Unit, San Carlo Hospital, Potenza, Italy
  • 4Gastroenterology and Digestive Endoscopy Unit, General Hospital, Perugia, Italy

Abstract

Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

Keyword

Clipping; Digestive endoscopy; Endoclips; Gastrointestinal bleeding; Over-the-scope clip

Figure

  • Fig. 1. Physical and functional features of through-the-scope (TTS) clips. +++, best performance; ++, good performance; +, medium perfor­mance.

  • Fig. 2. Main features of the over-the-scope clip (OTSC).


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