Endoscopic clipping for gastrointestinal bleeding: emergency and prophylactic indications

Amaury Teixeira Xavier; Julia Faria Campos; Lucinda Robinson; Elmar José Moreira Lima; Luiz Claudio Miranda da Rocha; Vitor Nunes Arantes

Authors Amaury Teixeira Xavier, Julia Faria Campos, Lucinda Robinson, Elmar José Moreira Lima, Luiz Claudio Miranda da Rocha, Vitor Nunes Arantes.

Abstract

Endoscopic clipping has become a common practice among endoscopists. Several models are available, most frequently being introduced via the working channel of the endoscope (throughthe-scope); however, larger clips can also be mounted onto the distal tip of the endoscope (overthe-scope). The main indications for endoclip placement include providing effective mechanical hemostasis for bleeding lesions and allowing endoscopic closure of gastrointestinal perforations. Endoclips can also be used prophylactically after endoscopic resection; however, this practice is still controversial. This review discusses the main indications for endoscopic clipping in the esophagus, stomach, duodenum and colon to manage acute bleeding lesions, and the criteria to be used in the prevention of delayed post-polypectomy bleeding.

Keywords Endoclip, mechanical hemostasis, gastrointestinal bleeding, prophylaxis, postpolypectomy

Ann Gastroenterol 2020; 33 (6): 563-570