Poster abstracts
Su1047 IS OVER-THE-SCOPE-CLIP AN EFFECTIVE RESCUE THERAPY FOR SERIOUS VARICEAL BLEEDING?

https://doi.org/10.1016/j.gie.2020.03.1893Get rights and content

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Background

Over-the-scope-clip (OTSC) has potency to achieve haemostasis of various bleeding GI lesions. Whether it is effective in variceal bleeding is not fully determined.

Aim

We aimed that to evaluate the successfulness and safety of OTSC for endoscopic hemostasis in patients with variceal bleeding in point of a first line treatment or rescue therapy.

Methods

Sequential patients who have serious upper GI bleeding due to varices undergoing endoscopic hemostasis using OTSC was evaluated. While the OTSC-system has been loaded on the scope the lesion was suctioned into the transparent cap without using grasping forceps and then the clip fired. All patients underwent second look endoscopy after the procedure on first and seventh days. Primary hemostasis success, recurrent bleeding rate, complications, and 6-month follow-up clinical outcomes analyzed.

Results

During a 24-months period, 21 consecutive patients were evaluated (14 male) with a mean age of 38 (range 28-79) years, a mean hemoglobin of 7 (range 6.5 to 9) g/dl. All patients had received packed red blood cells with the mean being 4 (range 4- 11) units. Fourteen patients had been failed with hemostatic treatment using currently available endoscopic methods, while 7 patients have not been taken previously any endoscopic therapy. Reasons for bleeding in rescue treatment group were anastomotic

Conclusions

OTSC seems to be a safe endoscopic treatment method that can be used to getting hemostasis in acute variceal bleeding especially as a rescue treatment. Its use for fundal varices as first-line therapy can be considered as a bridge to standardized synthetic glue injection therapy, until sufficient data for primary care efficiency would be verified by comprehensive, randomized controlled studies.

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