Over-the-Scope Clip Use in Initial Endoscopic Treatment of Upper GI Bleeding

In a randomized, controlled trial, OTSC use reduced rebleeding compared with standard endoscopic treatments.

Despite numerous advances in the management of patients with upper gastrointestinal (GI) bleeding, rebleeding remains a major cause of morbidity and mortality. Over-the-scope clips (OTSCs) have been shown to reduce further bleeding in a randomized, controlled trial (RCT) in patients with rebleeding (NEJM JW Gastroenterol Aug 2018 and Gastroenterology 2018; 155:674). Now, results are available from the first RCT of OTSCs for initial therapy of upper GI bleeding.

Investigators randomized 53 patients with severe upper GI bleeding to undergo endoscopic therapy with an OTSC (n=25) or standard endoscopic therapy (n=28) consisting of injection of dilute epinephrine along with either through-the-scope clips or multipolar electrocautery probes. Reble…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute