Abstract
We conducted an uncontrolled study to evaluate an improved metallic clip (Olympus
hemoclip) for the endoscopic treatment of nonvariceal gastrointestinal bleeding. A
total of 88 patients (mean age 63 ± 14, 60 males) with bleeding from a wide range
of sources were treated. Seventy-eight patients had active bleeding (spurting in 50,
oozing in 28) and 10 patients had a nonbleeding visible vessel. Initial hemostasis
was achieved in all patients with active bleeding. A total of 255 clips were placed
(average of 2.9 clips per patient, range of 1-10 clips). Spurting arterial bleeders
required more clips on average than oozing bleeders (3.2 versus 2.7); active bleeders
required more clips than cases with nonbleeding visible vessels (3.0 versus 2.2).
Mean follow-up was 397 ± 148 days. Recurrent bleeding was observed in 5 patients,
all of whom had active bleeding on initial presentation. Rebleeding was successfully
treated with hemoclips in 4 patients and one patient underwent surgery. Clips appeared
to be retained well; early clip dislodgement resulted in rebleeding in only 1 patient.
No complications resulted from this treatment. Clips did not impair healing of peptic
ulcers. We conclude that endoscopic hemoclip placement is a highly effective and safe
method for treating nonvariceal gastrointestinal bleeding and deserves comparative
studies with other methods of endoscopic hemostasis.
