Hemostatic forceps in various gastrointestinal bleeding scenarios: A single center comparative study with endoclip

Abstract

Abstract Endoclip is currently the preferred tool for endoscopic hemostasis in many endoscopic units. But, due to some technical limitations of endoclip and success of hemostatic forceps in hemostasis during endoscopic submucosal dissection (ESD), we aimed to study the efficiency and safety of hemostatic forceps in treating various causes of gastrointestinal (GI) bleeding. Retrospectively, we reviewed the files of patients treated in Al-ahsa hospital endoscopy unit during the period from 1 January 2018 to 30 November 2018. We enrolled 33 patients with GI bleeding that necessitate endoscopic treatment. During hemostatic forceps use, the blood was washed out using a water-jet-equipped, single-channel gastroscope. The bleeding points were pinched and gently retracted with hemostatic forceps. Monopolar electrocoagulation was performed using an electrosurgical current generator. Three patients suffered from post-sphincterotomy bleeding that treated initially with hemostatic forceps with 100% primary hemostasis without complications. Fifteen patients were treated with endoclipping with 100% primary hemostasis and two patients (13%) had rebleeding. The procedure duration was 8.53 ± 3.58 min. Hemostatic forceps was used as a primary tool for hemostasis in another 15 patients with achieved hemostasis in all patients without any subsequent complications. The procedure duration was 5.27 ± 2.05 min (P = 0.005). In conclusion, hemostatic forceps can be an effective, fast, as well as safe alternative approach for GI bleeding of various origins.