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Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery

BACKGROUND: Endoscopic resection of duodenal subepithelial lesions (SELs) is a difficult procedure with a high risk of perforation. At present, dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge. AIM: To evaluate the effectiveness and safety of...

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Autores principales: Wang, Zhen-Zhen, Zhou, Xian-Bin, Wang, Yi, Mao, Xin-Li, Ye, Li-Ping, Yan, Ling-Ling, Chen, Ya-Hong, Song, Ya-Qi, Cai, Yue, Xu, Shi-Wen, Li, Shao-Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475004/
https://www.ncbi.nlm.nih.gov/pubmed/34629812
http://dx.doi.org/10.3748/wjg.v27.i35.5958
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author Wang, Zhen-Zhen
Zhou, Xian-Bin
Wang, Yi
Mao, Xin-Li
Ye, Li-Ping
Yan, Ling-Ling
Chen, Ya-Hong
Song, Ya-Qi
Cai, Yue
Xu, Shi-Wen
Li, Shao-Wei
author_facet Wang, Zhen-Zhen
Zhou, Xian-Bin
Wang, Yi
Mao, Xin-Li
Ye, Li-Ping
Yan, Ling-Ling
Chen, Ya-Hong
Song, Ya-Qi
Cai, Yue
Xu, Shi-Wen
Li, Shao-Wei
author_sort Wang, Zhen-Zhen
collection PubMed
description BACKGROUND: Endoscopic resection of duodenal subepithelial lesions (SELs) is a difficult procedure with a high risk of perforation. At present, dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge. AIM: To evaluate the effectiveness and safety of an over-the-scope clip (OTSC) in the treatment of perforation post-endoscopic resection of duodenal SELs. METHODS: From May 2015 to November 2019, 18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs. Data comprising the rate of complete resection, closure of intraprocedural perforation, delayed bleeding, delayed perforation, and postoperative infection were extracted. RESULTS: The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%. The median perforation size was 1 cm in diameter. Seventeen patients had minor intraoperative bleeding, while the remaining 1 patient had considerable amount of bleeding during the procedure. Seven patients had postoperative abdominal infections, of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock. All 18 patients recovered and were discharged. No delayed bleeding or perforation was reported. The mean time taken to resume normal diet after the procedure was 6.5 d. The mean postoperative hospital stay was 9.5 d. No residual or recurrent lesions were detected during the follow-up period (15-66 mo). CONCLUSION: Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.
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spelling pubmed-84750042021-10-08 Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery Wang, Zhen-Zhen Zhou, Xian-Bin Wang, Yi Mao, Xin-Li Ye, Li-Ping Yan, Ling-Ling Chen, Ya-Hong Song, Ya-Qi Cai, Yue Xu, Shi-Wen Li, Shao-Wei World J Gastroenterol Retrospective Study BACKGROUND: Endoscopic resection of duodenal subepithelial lesions (SELs) is a difficult procedure with a high risk of perforation. At present, dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge. AIM: To evaluate the effectiveness and safety of an over-the-scope clip (OTSC) in the treatment of perforation post-endoscopic resection of duodenal SELs. METHODS: From May 2015 to November 2019, 18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs. Data comprising the rate of complete resection, closure of intraprocedural perforation, delayed bleeding, delayed perforation, and postoperative infection were extracted. RESULTS: The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%. The median perforation size was 1 cm in diameter. Seventeen patients had minor intraoperative bleeding, while the remaining 1 patient had considerable amount of bleeding during the procedure. Seven patients had postoperative abdominal infections, of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock. All 18 patients recovered and were discharged. No delayed bleeding or perforation was reported. The mean time taken to resume normal diet after the procedure was 6.5 d. The mean postoperative hospital stay was 9.5 d. No residual or recurrent lesions were detected during the follow-up period (15-66 mo). CONCLUSION: Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method. Baishideng Publishing Group Inc 2021-09-21 2021-09-21 /pmc/articles/PMC8475004/ /pubmed/34629812 http://dx.doi.org/10.3748/wjg.v27.i35.5958 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Retrospective Study
Wang, Zhen-Zhen
Zhou, Xian-Bin
Wang, Yi
Mao, Xin-Li
Ye, Li-Ping
Yan, Ling-Ling
Chen, Ya-Hong
Song, Ya-Qi
Cai, Yue
Xu, Shi-Wen
Li, Shao-Wei
Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title_full Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title_fullStr Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title_full_unstemmed Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title_short Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
title_sort effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475004/
https://www.ncbi.nlm.nih.gov/pubmed/34629812
http://dx.doi.org/10.3748/wjg.v27.i35.5958
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