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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Retrospective Study Of 189 Cases Of Acute Perforated Peptic Ulcer: Safety And Efficacy Of Over-the-scope-clip Based Endoscopic Closure.

Retrospective study of 189 cases of acute perforated peptic ulcer: safety and efficacy of over-the-scope-clip based endoscopic closure.

Wei-Jia You1, Ting-Ting Lian1, Ou Qian1

  • 1Endoscopic Center, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Fuzhou, 350004, Fujian, China.

Surgical Endoscopy
|June 17, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Over-the-scope clip (OTSC) closure offers improved outcomes for acute perforated peptic ulcer (PPU) patients without sepsis. This minimally invasive approach reduces hospital stay and speeds recovery compared to traditional methods.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Clinical Outcomes Research

Background:

  • Acute perforated peptic ulcer (PPU) presents significant clinical challenges.
  • Treatment options include over-the-scope clip (OTSC) closure, non-surgical management, and surgical intervention.
  • Evaluating the comparative effectiveness and safety of these approaches is crucial for patient care.

Purpose of the Study:

  • To compare clinical outcomes of acute PPU patients treated with OTSC, non-surgical, and surgical methods.
  • To assess the efficacy and safety of OTSC closure for PPU.
  • To identify risk factors associated with sepsis in PPU patients.

Main Methods:

  • Retrospective analysis of clinical outcomes including hospital stay, antibiotic use, diet resumption, and mortality.
Keywords:
ComplicationsOver-the-scope clip system (OTSC)Peptic ulcerPerforation

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  • Binary Logistic regression to identify sepsis risk factors in PPU.
  • Patient stratification into OTSC, non-surgical, and surgical groups.

    • Main Results:

    • OTSC closure was performed within 24 hours for 88.71% of patients in the OTSC group.
    • OTSC and non-surgical groups had similar, shorter hospital stays than the surgical group (p<0.05).
    • OTSC group showed significantly shorter antibiotic use and faster oral feeding resumption (p<0.05). No significant mortality difference was observed between groups.
    • Lower albumin, older age, and elevated creatinine were associated with increased sepsis risk.

    Conclusions:

    • OTSC closure is effective in improving clinical outcomes for acute PPU patients without sepsis.
    • Factors like age, hypoalbuminemia, and renal dysfunction increase sepsis risk.
    • Sepsis and multiorgan dysfunction are associated with mortality in PPU patients.
    Prognosis