Endoscopy 2021; 53(S 01): S81
DOI: 10.1055/s-0041-1724453
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Saturday, 27 March 2021 12:00 – 12:45 Upper GI endoscopy: Complications, bleeding, and more Room 6

Treatment Of Duodenal Ulcer Bleeding - Efficacy Of Traumatic and Atraumatic Over-The-Scope-Clips (OTSC) – A Multicenter Retrospective Analysis

M Hollenbach
1   University of Leipzig Medical Center, Division of Gastroenterology, Medical Department II, Leipzig, Germany
,
A Schmidt
2   University of Freiburg, Department of Medicine II, Medical Center, Faculty of Medicine, Freiburg, Germany
,
A Decker
2   University of Freiburg, Department of Medicine II, Medical Center, Faculty of Medicine, Freiburg, Germany
,
O Möschler
3   Department of Internal Medicine/Gastroenterology, Marienhospital Osnabrück, Osnabrück, Germany
,
C Jung
4   AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy
,
N Mechie
5   Sana Clinic Offenbach, Division of Gastroenterology, Offenbach, Germany
,
T Barhoom
5   Sana Clinic Offenbach, Division of Gastroenterology, Offenbach, Germany
,
A Hegelein
5   Sana Clinic Offenbach, Division of Gastroenterology, Offenbach, Germany
,
R Knoop
6   University of Göttingen Medical Center, Division of Gastroenterology, Göttingen, Germany
,
T Blasberg
5   Sana Clinic Offenbach, Division of Gastroenterology, Offenbach, Germany
,
E Wedi
5   Sana Clinic Offenbach, Division of Gastroenterology, Offenbach, Germany
› Author Affiliations
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    Aims The over-the-scope-clip (OTSC) substantially improved the endoscopic armamentarium for the treatment of severe gastrointestinal bleeding and can potentially overcome limitations of standard clips. Recent data indicated superiority of OTSC in hemostasis as first and second line therapy. However, the impact of the OTSC design (traumatic (-t) or atraumatic (-a) type) in particular in duodenal ulcer bleeding has not been analyzed thus far.

    Methods Retrospective analysis of a prospective collected database from 2009 until 2020 of 6 German endoscopic centers. All patients who underwent emergency endoscopy and were treated by OTSC for duodenal ulcer bleeding were included to the analysis. Proportions of OTSC-t and OTSC-a were analyzed by chi-square-test, Mann-Whitney-U- or Students’ t-test.

    Results 173 patients (93 OTSC-a, 80 OTSC-t) were included to the final analysis. The baseline characteristics age (71.2 y vs. 71.6 y, p=0.255), gender (male gender: 69.9 % vs. 67.5 %, p=0.735), anticoagulant therapy (32.9 % vs. 43.0 %, p=0.176) and Rockall-Score (7.2 vs. 7.4, p=0.917) were comparable between both groups. However, OTSC-a group showed significantly less active bleeding ulcers (Forrest Ia/b) than OTSC-t group (51.1 % vs. 62.5 %, p=0.020). OTSC-t was more often use as first-line treatment (95 % vs. 77.8 %, p=0.004). Initial bleeding hemostasis (OTSC-a: 93.5 %, OTSC-t: 90 %, p=0.421) or bleeding-associated mortality (OTSC-a: 3.2 %, OTSC-t: 7.8 %, p=0.125) were not significantly different between both groups but OTSC-t revealed a dramatically higher rate of rebleeding (37.2 % vs. 6.5 %, p<0.001).

    Conclusions OTSC-a should be the standard of care for duodenal ulcer bleeding if the endoscopist aims for an over-the-scope-clip.

    Citation: Hollenbach M, Schmidt A, Decker A et al. OP196 TREATMENT OF DUODENAL ULCER BLEEDING - EFFICACY OF TRAUMATIC AND ATRAUMATIC OVER-THE-SCOPE-CLIPS (OTSC) – A MULTICENTER RETROSPECTIVE ANALYSIS. Endoscopy 2021; 53: S81.


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    Publication History

    Article published online:
    19 March 2021

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