CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(08): E1086-E1090
DOI: 10.1055/a-1197-6177
Original article

Endoscopic Doppler probe ultrasonography for detecting blood flow at post-endoscopic submucosal dissection ulcers of the stomach

Yasutoshi Shiratori
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Takashi Ikeya
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Noriaki Oguri
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Ayaka Takasu
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Takeshi Okamoto
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Katsuyuki Fukuda
Division of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
› Author Affiliations

Abstract

Background and study aims The rate of early rebleeding after endoscopic submucosal dissection (ESD) for early gastric cancer ranges from 5 % to 38 %, despite application of preventive methods. Post-ESD rebleeding may be caused by “invisible” vessels that may not be detectable using ultrasonographic techniques. Recently, Doppler probe ultrasonography (DOP) has been used in endoscopy. Because little is known about the usefulness of DOP for decreasing the post-ESD rebleeding rate, we performed a preliminary case series study.

Patients and methods Twelve patients underwent DOP for post-ESD ulcer evaluation after visible vessel coagulation. In this study, the novel DOP system used in the vascular surgery department was used. DOP-positive invisible vessels were shown as a pulse wave on the monitor.

Results No (0 %) cases of post-ESD rebleeding occurred. Twenty invisible vessels were detected, and 13 were subjected to additional coagulation up to a depth of 3 mm. Mean DOP procedure time was 11.6 minutes (range: 8–18 minutes). In these latter cases, disappearance of the Doppler pulse wave was confirmed. No early rebleeding or other adverse events were experienced.

Conclusion DOP is a safe and feasible method for detecting invisible vessels in post-ESD ulcers. Further investigation of the clinical relevance is warranted.



Publication History

Received: 05 February 2020

Accepted: 18 May 2020

Article published online:
21 July 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 
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