Background and Study Aims: Technical difficulties have been experienced in endoscopic hemoclipping on the posterior
wall of the body of the stomach because the angle of approach is tangential. It has
been suggested that the use of a transparent cap on the tip of the endoscope could
help to solve this problem. The purpose of this study was to examine the efficacy
of endoscopic hemoclipping using a transparent cap over the tip of the endoscope.
Patients and Methods: A total of 74 patients with a bleeding peptic ulcer or stigmata of recent hemorrhage
underwent endoscopic hemoclipping. Technical difficulty in hemoclipping was experienced
in 18 patients and the transparent cap was used in these cases. We therefore conducted
a nonrandomized prospective study to compare bleeding control with the hemoclip with
and without the aid of a transparent cap.
Results: There were no statistically significant differences between the patients treated
with the cap and those treated without the cap with regard to the initial hemostasis
rate (94.4 % vs. 91.1 %), the rebleeding rate (11.7 % vs. 11.8 %), or the permanent
hemostasis rate (94.4 % vs. 96.4 %).
Conclusions: Although there was no statistically significant difference between patients treated
with or without a transparent cap, hemoclipping with the aid of the cap made it possible
to clip a lesion too tangential to be clipped without it. However, this study did
not compare conventional hemoclipping with hemoclipping using a cap because the cap
was only used in cases in which conventional clipping had failed.
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I. S. Chung, M. D.
Kang Nam St. Mary's Hospital
53 Banpo-dong · Seocho-gu · Seoul 137-040 · South Korea
Fax: + 82-2-3779-1331
Email: isc@cmc.cuk.ac.kr
