Endoscopic hemoclip versus triclip placement in patients with high-risk peptic ulcer bleeding.

Abstract

Hemoclip placement is an effective endoscopic therapy for peptic ulcer bleeding. Triclip is a novel clipping device with three prongs over the distal end. So far, there is no clinical study concerning the hemostatic effect of triclip placement. To determine the hemostatic effect of the triclip as compared with that of the hemoclip. A total of 100 peptic ulcer patients with active bleeding or nonbleeding visible vessels received endoscopic therapy with either hemoclip (N = 50) or triclip placement (N = 50). After obtaining initial hemostasis, they received omeprazole 40 mg intravenous infusion every 12 h for 3 days. The main outcome assessment was hemostatic rate and rebleeding rate at 14 days. Initial hemostasis was obtained in 47 patients (94%) of the hemoclip group and in 38 patients (76%) of the triclip group (P= 0.011). Rebleeding episodes, volume of blood transfusion, the hospital stay, numbers of patients requiring urgent operation, and mortality were not statistically different between the two groups. Hemoclip is superior to triclip in obtaining primary hemostasis in patients with high-risk peptic ulcer bleeding. In bleeders located over difficult-to-approach sites, hemoclip is more ideal than triclip.