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Frederik Elbke Hansen1, Magnus Ploug2, Gitte Maria Jørgensen3

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Ugeskrift for Laeger
|September 5, 2024
PubMed
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Over-the-scope clips (OTSC) and topical hemostatic agents (THA) may improve endoscopic hemostasis for peptic ulcer bleeding (PUB). Prophylactic embolization (PE) can reduce rebleeding risk in high-risk patients.

Area of Science:

  • Gastroenterology and Endoscopy
  • Interventional Radiology

Background:

  • Peptic ulcer bleeding (PUB) remains a significant clinical challenge.
  • Conventional endoscopic treatments have limitations in achieving hemostasis for some PUB cases.

Purpose of the Study:

  • To review the evidence for advanced hemostatic modalities in peptic ulcer bleeding.
  • To assess the efficacy of over-the-scope clips (OTSC), topical hemostatic agents (THA), and prophylactic embolization (PE).

Main Methods:

  • Systematic review of existing literature on OTSC, THA, and PE for PUB.
  • Evaluation of studies reporting hemostasis rates, rebleeding rates, and need for surgery.

Main Results:

  • OTSC and THA show potential for increasing endoscopic hemostasis in refractory PUB.

Related Experiment Videos

  • PE, when used adjunctively after endoscopic hemostasis in high-risk patients, can decrease rebleeding and surgical intervention.

    • Conclusions:

    • OTSC and THA represent valuable additions to the endoscopic management of PUB.
    • Prophylactic embolization is a viable strategy to prevent rebleeding in select high-risk PUB patients.
    • Integrating these modalities into local protocols may enhance patient outcomes for PUB.