Comparison of monopolar hemostatic forceps with soft coagulation versus hemoclip for peptic ulcer bleeding: a randomized trial (with video) Bilal Toka,

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Presentation transcript:

Comparison of monopolar hemostatic forceps with soft coagulation versus hemoclip for peptic ulcer bleeding: a randomized trial (with video) Bilal Toka, MD, Ahmet Tarik Eminler, Cengiz Karacaer, MD, Mustafa Ihsan Uslan, Aydin Seref Koksal, Erkan Parlak Gastrointestinal Endoscopy Volume 89, Issue 4, Pages 792-802 (April 2019) DOI: 10.1016/j.gie.2018.10.011 Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Hemoclip treatment. A, A visible vessel is seen at the edge of an ulcer on the lesser curvature of the antrum. B, It is effectively grasped with a hemoclip to achieve hemostasis. Gastrointestinal Endoscopy 2019 89, 792-802DOI: (10.1016/j.gie.2018.10.011) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Application of MHFSC to an oozing visible vessel with a diameter smaller than 2 mm. A, Ulcer with an oozing vessel is seen on the anterior wall of the bulbus. B, MHFSC is applied to the center of the vessel after epinephrine injection. C, Immediately after hemostasis. D, Five days after hemostasis. MHFSC, Monopolar hemostatic forceps with soft coagulation. Gastrointestinal Endoscopy 2019 89, 792-802DOI: (10.1016/j.gie.2018.10.011) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Application of MHFSC to an oozing visible vessel with a diameter larger than 2 mm. A, Ulcer with an oozing vessel is seen on the anterior wall of the bulbus. B, Epinephrine is injected initially. C, The center of the vessel was coagulated after coagulation was ensured at 4 edges of the vessel (4+1 contact method). D, Immediately after hemostasis. MHFSC, Monopolar hemostatic forceps with soft coagulation. Gastrointestinal Endoscopy 2019 89, 792-802DOI: (10.1016/j.gie.2018.10.011) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Flow diagram of the study population. INR, International normalized ratio; PLT, platelet; MHFSC, monopolar hemostatic forceps with soft coagulation; HC, hemoclip. Gastrointestinal Endoscopy 2019 89, 792-802DOI: (10.1016/j.gie.2018.10.011) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Results of endoscopic treatments. MHFSC, Monopolar hemostatic forceps with soft coagulation; HC, hemoclip. Gastrointestinal Endoscopy 2019 89, 792-802DOI: (10.1016/j.gie.2018.10.011) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions