Endoscopy 2022; 54(S 01): S284
DOI: 10.1055/s-0042-1745408
Abstracts | ESGE Days 2022
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THE ROLE OF THE ENDOSCOPIC DOPPLER PROBE IN NON VARICEAL UPPER GASTROINTESTINAL BLEEDING: A SYSTEMATIC REVIEW AND META-ANALYSIS

N. Chapelle
1   University Hospital of Nantes, Department of Gastroenterology, Nantes, France
,
M. Martel
2   McGill University Health Center, Research Institute, Montreal, Canada
,
M. Bardou
3   University Hospital, Dijon, Dijon, France
,
M. Almadi
4   King Saud University, Riyadh, Saudi Arabia
,
A. Barkun
5   McGill University Health Center, Department of Gastroenterology, Montreal, Canada
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Aims The effectiveness of the Doppler Endoscopic Probe (DEP) inserted through the operating channel in non-variceal upper gastrointestinal bleeding (NVUGIB). We aimed to perform a systematic review characterizing the effectiveness of DEP in patients with NVUGIB.

Methods A literature search until July 2021 using OVID MEDLINE, EMBASE, and ISI Web of Knowledge identified studies addressing DEP in NVUGIB. A series of meta-analyses were performed assessing outcomes amongst observational and intervention studies for DEP signal positive and negative lesions as well as DEP-assisted versus standard endoscopies. The primary outcome was “overall rebleeding”; secondary outcomes included all-cause mortality, bleeding-related mortality, need for surgery, length of stay, ICU stay and angiography.

Results Fourteen studies were included from 1911 citations identified. Observational studies compared bleeding lesions with DEP positive versus DEP negative signals 11 studies, n=800 pre-hemostasis that includes 5 studies, n=148 with post-hemostasis data. Three interventional studies (n=308) compared DEP-assisted to standard endoscopy management. DEP signal positive versus negative lesions both prior to or following any possible hemostasis were at greater risk of overall rebleeding (OR=6.54; 95%CI 2.36; 18.11,I2=46% and OR=25.96; 95%CI 6.74; 100.0, I2=0%respectively). The use of DEP during endoscopy significantly reduced overall rebleeding rates (OR=0.27; 95%CI 0.14; 0.54). When removing outcomes analysis for which only one study was available, all evaluable outcomes were improved with DEP characterization of management guidance except for all-cause mortality.

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Fig. 1

Conclusions DEP-related information improves on sole visual determination of the rebleeding risk of a NVUGIB lesion with DEP-guided management resulting in decreased overall rebleeding, bleeding-related mortality and need for surgery.



Publication History

Article published online:
14 April 2022

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