Over-the-scope-clip applications for perforated peptic ulcer

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Innovation

Background:

• Perforated peptic ulcer (PPU) is a serious condition requiring prompt management.
• Traditional treatments for PPU can involve significant morbidity and mortality.
• Endoscopic interventions offer a less invasive alternative for managing gastrointestinal defects.

Purpose of the Study:

• To evaluate the efficacy of over-the-scope-clip (OTSC) endoscopic closure for treating perforated peptic ulcers (PPU).
• To compare OTSC closure outcomes against conservative management strategies in PPU patients.

Main Methods:

• A comparative study involving 106 patients diagnosed with PPU.
• Patients were treated with either OTSC (n=26) or conservative methods (n=80).
• Outcomes assessed included technical and clinical success, complications, mortality, time to oral feeding, hospital stay, and antibiotic use.

Main Results:

• OTSC achieved 100% technical and clinical success with no complications or mortality.
• Patients treated with OTSC resumed oral feeding significantly faster (median 3.5 days vs. 7.0 days).
• No additional surgeries were required for OTSC patients, unlike 30% in the conservative group.

Conclusions:

• OTSC-based endoscopic closure is a highly effective treatment for PPU, particularly for defects <15 mm.
• The technique demonstrates a high clinical success rate and leads to quicker patient recovery and oral feeding resumption.
• OTSC offers a safe and efficient alternative to conventional treatments for select PPU cases.