Over-the-Scope Clips Effectively Treat Recurrent Peptic Ulcer Bleeding

In a randomized, controlled trial, over-the-scope clip use was superior to standard endoscopic therapy.

Patients with recurrent bleeding from peptic ulcers after initial endoscopic therapy have high rates of further bleeding (>25%) after a second endoscopic treatment. Standard endoscopic therapies include a combination of injection of dilute epinephrine along with cautery or through-the-scope hemoclips.

To investigate whether the more recently available option of over-the-scope clip (OTSC) use provides more durable hemostasis in this setting, researchers randomized 66 patients with recurrent bleeding from peptic ulcers to treatment with OTSC use or standard therapy. Patients with further bleeding were allowed to cross over to the other treatment. The primary endpoint was further bleeding, a composite endpoint of persistent bleeding despite end…

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