USEFULNESS OF NEW-DESIGNED HEMOCLIP FOR CASES WITH ENDOSCOPIC PAPILLECTOMY

Aims Endoscopic papillectomy (EP) is less invasive treatment for duodenal papillary tumor compared with surgical operation such as pancreaticoduodenectomy. However, EP has high risk of complications like hemorrhage, pancreatitis, and perforation. Therefore, intraoperative treatments such as hemostasis and closure of mucosal defect are important for prevention of complication after EP. Although closure by side-viewing endoscope was difficult due to poor maneuverability of clip, new-designed hemoclip was recently developed which could overcome the problem. The present study was aimed to evaluate new-designed hemoclip for EP by comparison with general clip.

Methods This is a retrospective single-center study of all patients who underwent EP during May 2016 to October 2019. Patients were divided into two groups; Group S which closure was performed by new clips (Sure clip, Micro-Tech, Nanjing, China) and Group O which closure was performed by general clips. We analyzed closure time, number of clips, and delayed complications after EP as clinical outcomes.

Results During the period, EP was performed 41 cases. In detail, 13 cases were included in Group S, while remaining 28 cases were in Group O. The median age in the study was 62 years old (39-82). The median diameter of tumor in each group were 13mm in Group S and 11.5mm in Group O, respectively (p=0.19). The median number of clips for closure was 3 which was not significantly different between Group S and Group O. The median of closure time in Group S was significantly shorter than that in Group O (5 minutes vs 12 minutes, P=0.006). Overall hemorrhage after EP was 5 cases (12%). In detail, 1 case (7.7%) in S group and that in O group was 4 cases (14%) which was not significantly different (p=1.00).

Conclusions New-designed hemoclip was suggested to be useful for endoscopic closure after EP.