Review
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Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
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Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
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Clin Endosc 2022;55(3):339-346. Published online April 28, 2022
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DOI: https://doi.org/10.5946/ce.2021.249
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Abstract
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- Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.
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Citations
Citations to this article as recorded by

- Adverse Events of Endoscopic Clip Placement
Daryl Ramai, Smit S. Deliwala, Daniel Mozell, Antonio Facciorusso, Saurabh Chandan, Alana Persaud, Kelita Singh, Andrea Anderloni, Monique T. Barakat
Journal of Clinical Gastroenterology.2024; 58(1): 76. CrossRef - Right tool for the right bleeder
Ding Ek Toh, Sheng Wei Lo, Andrew Tsoi, Jonathan P Segal, Joshua Butt
Gut.2024; 73(1): 206. CrossRef - Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?
Sun Gyo Lim
Clinical Endoscopy.2024; 57(2): 191. CrossRef - Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
John Joyce, Vishnu Kumar, Dayana Nasr, Ganesh Aswath, Hafiz M. Khan, Savio John
Journal of Investigative Medicine High Impact Case Reports.2024;[Epub] CrossRef - Comparison of mechanical and thermal therapy in upper gastrointestinal bleeding: an analysis of efficacy outcomes
Rahul Karna, Bandhul Hans, Thayer Nasereddin, Dhruv Chaudhary, Manish Dhawan
Baylor University Medical Center Proceedings.2024; 37(5): 734. CrossRef - Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study
Zie Hae Lim, Seung In Seo, Dae-Seong Myung, Seung Han Kim, Han Hee Lee, Selen Kim, Bo-In Lee
Clinical Endoscopy.2024; 57(5): 620. CrossRef - Evaluating the efficacy of a novel hemostatic powder compared with traditional treatments in nonvariceal upper GI bleeding: a multicenter, randomized, noninferiority study
Da Hyun Jung, Jun Chul Park, Joon Sung Kim, Moon Won Lee, Hyuk Lee, Gwang Ha Kim
Gastrointestinal Endoscopy.2024;[Epub] CrossRef - Sustained Hemostasis With the Padlock™ Over-the-scope Clip for Gastric Fundus Dieulafoy’s Lesion in the Setting of Anticoagulation Following Hemorrhagic Shock From Two Dieulafoy’s Lesions
Jonathan J Cho, Chelsea M Forbes, Benjamin D Fiore, Joshua D McCarron, Leybelis Padilla
Military Medicine.2023; 188(9-10): e3265. CrossRef - Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clinical Endoscopy.2023; 56(4): 423. CrossRef - Novel removable endoscopic clip: Usefulness in failure of traction method during endoscopic submucosal dissection
Nobukazu Agatsuma, Takahiro Utsumi, Hirokazu Higuchi, Takahiro Inoue, Yukari Tanaka, Yuki Nakanishi, Hiroshi Seno
Endoscopy.2023; 55(S 01): E1031. CrossRef
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Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New?
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Over-the-Scope Clip in the Treatment of Gastrointestinal Leaks and Perforations
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Mike T. Wei, Ji Yong Ahn, Shai Friedland
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Clin Endosc 2021;54(6):798-804. Published online November 30, 2021
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DOI: https://doi.org/10.5946/ce.2021.250
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Abstract
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- While perforations, postoperative fistulas, and leaks have traditionally led to surgical or interventional radiology consultation for management, the introduction of the over-the-scope clip has allowed increased therapeutic possibilities for endoscopists. While primarily limited to case reports and series, the over-the-scope clip successfully manages gastrointestinal bleeding, perforations, as well as postoperative leaks and fistulas. Retrospective studies have demonstrated a relatively high success rate and a low complication rate. Given the similarity to variceal banding equipment, the learning curve with the over-the-scope clip is rapid. However, given the higher risk of procedures involving the use of the over-the-scope clip, it is essential to obtain the scope in a stable position and grasp sufficient tissue with the cap using a grasping tool and/or suction. From our experience, while closure may be successful in lesions sized up to 3 cm, successful outcomes are obtained for lesions sized <1 cm. Ultimately, given the limited available data, prospective randomized trials are needed to better evaluate the utility of the over-the-scope clip in various clinical scenarios, including fistula and perforation management.
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Citations
Citations to this article as recorded by

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Eduardo Rodríguez-Hernández, Masayoshi Yamada, Takayuki Yamazaki, Shunsuke Tsukamoto, Yutaka Saito
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Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef - Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef - Metabolic and bariatric surgery: an update from 2010
Bao-Ngoc Nasri, Robert B. Lim, James Ellsmere, Alisha R. Fernandes, Daniel B. Jones
Current Problems in Surgery.2024; 61(11): 101549. CrossRef - Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Cierre de fistula esófago-yeyunal post operatoria con clips endoscópicos de titanio y over-the-scope clip: reporte de caso
Lázaro Arango Molano, Andrés Sánchez Gil, Gian Núñez Rojas, Herney Solarte Pineda, Santiago Salazar Ochoa
Revista de Gastroenterología del Perú.2024; 44(4): 406. CrossRef - Use of anchor pronged clips to close complex polyp resection defects
Mike Tzuhen Wei, Shai Friedland
VideoGIE.2023; 8(6): 245. CrossRef - Novel endoscopic management of gastroenterological anastomosis leakage by injecting gel-forming solutions: an experimental animal study
Yusuke Watanabe, Keiko Yamamoto, Zijian Yang, Haruna Tsuchibora, Masakazu Fujii, Masayoshi Ono, Shoko Ono, Takayuki Kurokawa, Naoya Sakamoto
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Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Clinical Endoscopy.2023; 56(4): 391. CrossRef - Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clinical Endoscopy.2023; 56(4): 423. CrossRef - Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population
Muaaz Masood, Donald Low, Shanley B. Deal, Richard A. Kozarek
Journal of Clinical Medicine.2023; 12(17): 5543. CrossRef - Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef - Endoscopic Management of Esophageal Cancer
Christopher Paiji, Alireza Sedarat
Cancers.2022; 14(15): 3583. CrossRef - Use of a novel dual-action clip for closure of complex endoscopic resection defects
Mike Tzuhen Wei, Shai Friedland
VideoGIE.2022; 7(11): 389. CrossRef
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Case Report
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Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report
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Sun Young Moon, Min Kyu Jung, Jun Heo
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Clin Endosc 2022;55(3):443-446. Published online May 25, 2021
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DOI: https://doi.org/10.5946/ce.2020.294
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Abstract
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- Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.
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Citations
Citations to this article as recorded by

- Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef - Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Clinical Endoscopy.2023; 56(4): 391. CrossRef - Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
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Original Article
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Endoscopic Management with a Novel Over-The-Scope Padlock Clip System
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Mahesh Kumar Goenka, Gajanan Ashokrao Rodge, Indrajeet Kumar Tiwary
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Clin Endosc 2019;52(6):574-580. Published online November 26, 2019
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DOI: https://doi.org/10.5946/ce.2019.122
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Abstract
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- Background
/Aims: The Padlock clip is a recently introduced over-the-scope clip (OTSC) that requires the use of an alternate technique and has a different design from previous OTSCs. However, data regarding its clinical use are limited. The aim of this study is to present our clinical experience using this novel Padlock clip system.
Methods
Between September 2018 and June 2019, 7 consecutive patients underwent Padlock clip application at our center by an experienced endoscopist. A Padlock clip was used for achieving hemostasis in 4 patients presenting with gastrointestinal (GI) bleeding, as well as for endoscopic full-thickness resection in the remaining 3 patients.
Results
All 7 patients achieved technical as well as clinical success, with absence of complications or rebleeding, during a follow-up of a minimum of 3 weeks. All patients were hospitalized post procedure for a minimum of 48 hours, and an absence of adverse events was noted in our patient population throughout the procedure and post-procedure period. Antiplatelet therapy was reinstated shortly after the application of the Padlock clip, with no GI bleeding observed.
Conclusions
The Padlock clip is a novel OTSC, with benefits that include safe, simple, and rapid deployment. Antiplatelet therapy may be reinstated for patients, when necessary, shortly after applying the Padlock clip due to full-thickness closure of the tissue.
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Citations
Citations to this article as recorded by

- Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon
Hisham Wehbe, Aditya Gutta, Mark A. Gromski
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 363. CrossRef - Advancements in endoscopic hemostasis for non-variceal upper gastrointestinal bleeding
Xue Jing Li, Brian M Fung
World Journal of Gastrointestinal Endoscopy.2024; 16(7): 376. CrossRef - Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
John Joyce, Vishnu Kumar, Dayana Nasr, Ganesh Aswath, Hafiz M. Khan, Savio John
Journal of Investigative Medicine High Impact Case Reports.2024;[Epub] CrossRef - Impact of Size on Endoluminal Approaches to Submucosal Tumors of the Stomach
Jad P. AbiMansour, Ryan J. Law
Foregut: The Journal of the American Foregut Society.2024;[Epub] CrossRef - Analysis of Reported Adverse Events Related to Over-the-Scope Clips: A MAUDE Database Analysis
Daniyal Abbas, Mohamed Abdallah, Khalid Ahmed, Abubaker O. Abdalla, Nicholas McDonald, Shifa Umar, Brian J. Hanson, Mohammad Bilal
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 106. CrossRef - Colonic diverticular bleeding: An update on pathogenesis and management
Sneha Annie Sebastian, Edzel Lorraine Co, Venkatesh Panthangi, Radha Bansal, Vaishnavi Narayanan, Shachi Paudel, Rabab Raja, Inderbir Padda, Babu P Mohan
Disease-a-Month.2023; 69(11): 101543. CrossRef - Endoscopic Recognition and Resection of Malignant Colorectal Polyps
Natalie Wilson, Moamen Gabr, Mohammad Bilal
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 385. CrossRef - Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review
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Gastrointestinal Disorders.2023; 5(3): 383. CrossRef - Boerhaave’s Syndrome: Better Late than Never – Delayed Management Using Endoscopic Over-the-Scope Clip
Arulprakash Sarangapani, Tarun J George, S Malathi
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M. Reyes Busta Nistal, Lourdes del Olmo Martínez, Benito Velayos Jimenez, Luis Fernández Salazar, Miguel Durà Gil
Gastroenterología y Hepatología.2022; 45: 99. CrossRef - The application of endoscopic loop ligation in defect repair following endoscopic full-thickness resection of gastric submucosal tumors originating from the muscularis propria layer
Guoxiang Wang, Yanli Xiang, Yangde Miao, Honggang Wang, Meidong Xu, Guang Yu
Scandinavian Journal of Gastroenterology.2022; 57(1): 119. CrossRef - OTSC (Padlock Clip) as a Rescue Endoscopic Method for a Severe Post-Bariatric Complication
Luiza L. Ramos, Ravi C. Marques, Hugo G. Guedes
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Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
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Lian Yong Li, Bai Wen Li, Parit Mekaroonkamol, Hui Min Chen, Shan Shan Shen, Hui Luo, Sunil Dacha, Yue Xue, Sarah Cristofaro, Steven Keilin, Field Willingham, Qiang Cai
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Awf Mouchli, Vikas Chitnavis
Cureus.2020;[Epub] CrossRef - Successful Endoscopic Removal of Toothpick Perforating Gastric Antrum With Over-the-Scope Padlock Clip Closure
Darshan Suthar, Elisabeth H Kramer, Harshit S Khara
Cureus.2020;[Epub] CrossRef
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Case Report
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Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management
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Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate
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Clin Endosc 2020;53(3):361-365. Published online October 28, 2019
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DOI: https://doi.org/10.5946/ce.2019.106
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Abstract
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Supplementary Material
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- Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.
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Citations
Citations to this article as recorded by

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Qi Gong, Aihong Yin, Zhi Wei
Asian Journal of Surgery.2024;[Epub] CrossRef - Successful Closure of a Tracheoesophageal Fistula Using an Over-The-Scope Clip
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Cureus.2021;[Epub] CrossRef - Over-the-Scope Clip-Associated Endoscopic Muscular Dissection for Seven Cases of Small Gastric Submucosal Tumor: A Video-Based Case Series
Xin Li, Rongfen Wei, Jianfu Qin, Fei Qin, Peng Peng, Mengbin Qin, Shiquan Liu, Jiean Huang, Piero Chirletti
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
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Original Article
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Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study
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Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
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Clin Endosc 2017;50(1):58-63. Published online October 31, 2016
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DOI: https://doi.org/10.5946/ce.2016.028
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Abstract
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- Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.
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Citations
Citations to this article as recorded by

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Alessandrino Terceiro de Oliveira, Márcio Alencar Barreira, José Wilson da Cunha Parente Júnior, José Ruver Lima Herculano Junior, Jeany Borges e Silva Ribeiro, Orleancio Gomes Ripardo de Azevedo, Paulo Roberto Cavalcante de Vasconcelos
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Hideaki Kawabata, Misuzu Hitomi, Shigehiro Motoi
Biomedicines.2019; 7(3): 54. CrossRef - Over‐the‐scope clip for acute esophageal variceal bleeding
Carolina Mangas‐Sanjuan, Belén Martínez-Moreno, Maryana Bozhychko, Luis Compañy, Juan Martinez, Francisco Ruiz, Juan Antonio Casellas, José Ramón Aparicio
Digestive Endoscopy.2019; 31(6): 712. CrossRef - Clinical outcomes of over-the-scope-clip system for the treatment of acute upper non-variceal gastrointestinal bleeding: a systematic review and meta-analysis
Chunyu Zhong, Shali Tan, Yutang Ren, Muhan Lü, Yan Peng, Xiangsheng Fu, Xiaowei Tang
BMC Gastroenterology.2019;[Epub] CrossRef - Endoscopic Management with a Novel Over-The-Scope Padlock Clip System
Mahesh Kumar Goenka, Gajanan Ashokrao Rodge, Indrajeet Kumar Tiwary
Clinical Endoscopy.2019; 52(6): 574. CrossRef - Over the Scope Clips for Treatment of Acute Nonvariceal Gastrointestinal Bleeding in Children Are Safe and Effective
Paul Tran, Joshua Carroll, Bradley A. Barth, Nandini Channabasappa, David M. Troendle
Journal of Pediatric Gastroenterology and Nutrition.2018; 67(4): 458. CrossRef - Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report
Jing Yu, Cheng-Ji Zhou, Pan Wang, Shou-Jiang Wei, Jin-Song He, Jin Tang
World Journal of Clinical Cases.2018; 6(15): 1047. CrossRef - New endoscopic techniques in treating gastrointestinal bleeding
Young Sin Cho
International Journal of Gastrointestinal Intervention.2018; 7(3): 131. CrossRef - Over-the-Scope Clip in the Management of Gastrointestinal Defect and Intractable Non-Variceal Bleeding
Hyungkil Kim
Clinical Endoscopy.2017; 50(1): 3. CrossRef - Hémorragies digestives : qui ? quand ? place des nouveaux traitements ?
D. Heresbach, A. Laquière
Acta Endoscopica.2017; 47(5): 281. CrossRef - Over-the-scope clip
Bhanwar Singh Dhandhu, Kumar Shwetanshu Narayan, Surinder Sultania, Sandeep Nijhawan
Journal of Digestive Endoscopy.2016; 07(02): 047. CrossRef
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Review
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Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding
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Jae-Young Jang
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Clin Endosc 2016;49(5):417-420. Published online September 30, 2016
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DOI: https://doi.org/10.5946/ce.2016.135
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Abstract
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- Peptic ulcer bleeding is an internal medical emergency. Endoscopic hemostasis has been shown to improve the survival rate of patients with peptic ulcer bleeding. Although the established hemostatic modalities, including injection, thermal therapy, and mechanical therapy, are effective in controlling peptic ulcer bleeding, hemostasis can be difficult to achieve in some cases. As a result, recent, new endoscopic hemostatic modalities, including over-the-scope clips, topical hemostatic sprays, and endoscopic ultrasonography-guided angiotherapy, have been developed.
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Citations to this article as recorded by

- Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
Clinical Endoscopy.2022; 55(3): 339. CrossRef - Mortality Trends of Gastrointestinal, Liver, and Pancreaticobiliary Diseases: A Hospital-Based Prospective Study in the Southeast of Iran
Mohammad Javad Zahedi, Sara Shafieipour, Mohammad Mahdi Hayatbakhsh Abbasi, Mohsen Nakhaie, Mohammad Rezaei Zadeh Rukerd, Mohammad Mehdi Lashkarizadeh, Farbood Noorbini, Mohammad Hasan Baghaei, Abbas Pourjafari, Ebrahim Aminian, Fatemeh Karami Robati, Aza
Middle East Journal of Digestive Diseases.2022; 14(4): 404. CrossRef - Urban-Rural Disparities and Temporal Trends in Peptic Ulcer Disease Epidemiology, Treatment, and Outcomes in the United States
Howard Guo, Angela Y. Lam, Abdel Aziz Shaheen, Nauzer Forbes, Gilaad G. Kaplan, Christopher N. Andrews, Michael Laffin, Siddharth Singh, Vipul Jairath, Anouar Teriaky, Jeffrey K. Lee, Christopher Ma
American Journal of Gastroenterology.2021; 116(2): 296. CrossRef - Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum
Volodymyr Mamchych, Sergiy Vereshchagin, Volodymyr Maksymchuk, Dmytro Maksymchuk
EUREKA: Health Sciences.2021; (2): 37. CrossRef - Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy
Hiroyuki Abe, Kenya Kamimura, Yoshihisa Arao, Junji Kohisa, Shuji Terai
Medicines.2021; 8(9): 53. CrossRef - Acute upper gastrointestinal bleeding: A review
Elroy Patrick Weledji
Surgery in Practice and Science.2020; 1: 100004. CrossRef - Acute gastroinstinal bleeding: a review
Elroy P. Weledji
International Journal of Surgery: Global Health.2020; 3(3): e18. CrossRef - Upper gastrointestinal bleeding: Is only an injection of epinephrine sufficient? Success rates by Forrest classification
Ahmet Surek, Eyup Gemici, Abdussamet Bozkurt, Mehmet Karabulut
Sanamed.2020; 15(3): 309. CrossRef - Endoscopic closure of iatrogenic colon perforation using dual-channel endoscope with an endoloop and clips: methods and feasibility data (with videos)
Ja Young Ryu, Byung Kwan Park, Won-Seok Kim, Kisung Kim, Jae Young Lee, Young Kim, Jae Yong Park, Beom Jin Kim, Jeong Wook Kim, Chang Hwan Choi
Surgical Endoscopy.2019; 33(4): 1342. CrossRef - Endoscopic Hemostatic Treatment of Peptic Ulcer Bleeding
Yeon Hwa Choe, Jun Chul Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 235. CrossRef
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Case Reports
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Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy
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Yoshihisa Arao, Yuichi Sato, Satoru Hashimoto, Hiroki Honda, Kazumi Yoko, Masaaki Takamura, Ken-ichi Mizuno, Masaaki Kobayashi
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Clin Endosc 2015;48(6):563-565. Published online November 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.6.563
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Abstract
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- A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.
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Citations
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- UEG Week 2016 Poster Presentations
United European Gastroenterology Journal.2016; 4(5_suppl): A157. CrossRef
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10,326
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71
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1
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Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
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Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
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Clin Endosc 2014;47(2):178-182. Published online March 31, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.2.178
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Abstract
PDF
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ePub
Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.
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Citations
Citations to this article as recorded by

- Experimental Evaluation of the Optimal Suture Pattern With a Flexible Endoscopic Suturing System
Peter Halvax, Michele Diana, Yoshihiro Nagao, Jacques Marescaux, Lee Swanström
Surgical Innovation.2017; 24(3): 201. CrossRef - Management of non-acute gastrointestinal defects using the over-the-scope clips (OTSCs): a retrospective single-institution experience
Joshua S. Winder, Afif N. Kulaylat, Jane R. Schubart, Hassan M. Hal, Eric M. Pauli
Surgical Endoscopy.2016; 30(6): 2251. CrossRef - Early endoscopic closure of colocutaneous fistula adjacent to unmatured low colorectal anastomosis with the Over-The-Scope Clip (OTSC)
Constantinos Avgoustou, K. Paraskeva
Hellenic Journal of Surgery.2016; 88(3): 193. CrossRef - Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
Nobuyoshi Takeshita, Khek Yu Ho
Clinical Endoscopy.2016; 49(5): 438. CrossRef
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6,683
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