Endoscopic closure of small gastrointestinal perforations using endoclips

J. H. Hyun, Hoon-Jai Chun, Yoon Tae Jeen, S. J. Lee, K. H. Kim, H. J. Park, Soon-Ho Um, Sang Woo Lee, J. H. Choi, Chang Duck Kim, H. S. Ryu

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Abstract

Background: The improvement of both endoscopic technique and device system made therapeutic endoscopic procedures more clinically available. But the most worrisome complication is perforation. Generally, gastrointestinal(GI) perforation secondary to endoscopic procedures are treated by surgery. The clipping apparatus was originally developed by Hayashi in 1975 to bring about endoscopic hemostasis of bleeding ulcers. The currently available endoscopic metallic clipping has been widely used to mark lesion, ligate esophageal varices and close mucosal defects following endoscopic mucosal resections. Recently Binmoeller et al described closure of a small perforation in stomach using Endoclips [1], however, no additional study has been reported. We evaluate the clinical availability of Endoclips for the management of small GI perforations. Material and Methods: A total 5 patients with GI perforations following endoscopic procedures were included in this study. The diseases of patients are flat adenoma of stomach 1 case, early gastric cancer 1 case, GIST(gastrointestinal stromal tumor) 2 cases and early colon cancer 1 case. Therapeutic endoscopic procedures causing GI perforations were either endoscopic mucosal resection or incisional enucleation. Endoscopy was performed for closing the perforation using metallic clips(MD 850, Olympus Corp.) and clip delivery catheters(HX-3L, HX-5LR-1, Olympus Corp.) Results: Diagnosis Location Age Sex Size (cm) Procedure Result EGC body, post. wall 75 F 2.5 × 1.3 EMR success GIST fundus 59 F 1.3 × 1.2 IE success GIST fundus 56 F 3.3 × 3.0 IE success Flat adenoma body, ant. wall 66 M 2.3 × 1.7 EMR success ECC sig. colon 55 F 2.1 × 1.1 EMR success EMR: endoscopic mucosal resection IE: incisional enucleation No complication secondary to clipping occured. Follow up endoscopy showed complete healing, with scar. Conclusions: Endoclips can be applicated to close small GI perforations and thus may help to avoid surgery.

Original languageEnglish
JournalGastrointestinal Endoscopy
Volume47
Issue number4
Publication statusPublished - 1998 Dec 1

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Gastrointestinal Stromal Tumors
Surgical Instruments
Adenoma
Endoscopy
Stomach
Endoscopic Hemostasis
Ants
Esophageal and Gastric Varices
Colonic Neoplasms
Ulcer
Stomach Neoplasms
Cicatrix
Colon
Catheters
Hemorrhage
Equipment and Supplies
Therapeutics
Endoscopic Mucosal Resection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Hyun, J. H., Chun, H-J., Jeen, Y. T., Lee, S. J., Kim, K. H., Park, H. J., ... Ryu, H. S. (1998). Endoscopic closure of small gastrointestinal perforations using endoclips. Gastrointestinal Endoscopy, 47(4).

Endoscopic closure of small gastrointestinal perforations using endoclips. / Hyun, J. H.; Chun, Hoon-Jai; Jeen, Yoon Tae; Lee, S. J.; Kim, K. H.; Park, H. J.; Um, Soon-Ho; Lee, Sang Woo; Choi, J. H.; Kim, Chang Duck; Ryu, H. S.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 01.12.1998.

Research output: Contribution to journalArticle

Hyun, JH, Chun, H-J, Jeen, YT, Lee, SJ, Kim, KH, Park, HJ, Um, S-H, Lee, SW, Choi, JH, Kim, CD & Ryu, HS 1998, 'Endoscopic closure of small gastrointestinal perforations using endoclips', Gastrointestinal Endoscopy, vol. 47, no. 4.
Hyun, J. H. ; Chun, Hoon-Jai ; Jeen, Yoon Tae ; Lee, S. J. ; Kim, K. H. ; Park, H. J. ; Um, Soon-Ho ; Lee, Sang Woo ; Choi, J. H. ; Kim, Chang Duck ; Ryu, H. S. / Endoscopic closure of small gastrointestinal perforations using endoclips. In: Gastrointestinal Endoscopy. 1998 ; Vol. 47, No. 4.
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abstract = "Background: The improvement of both endoscopic technique and device system made therapeutic endoscopic procedures more clinically available. But the most worrisome complication is perforation. Generally, gastrointestinal(GI) perforation secondary to endoscopic procedures are treated by surgery. The clipping apparatus was originally developed by Hayashi in 1975 to bring about endoscopic hemostasis of bleeding ulcers. The currently available endoscopic metallic clipping has been widely used to mark lesion, ligate esophageal varices and close mucosal defects following endoscopic mucosal resections. Recently Binmoeller et al described closure of a small perforation in stomach using Endoclips [1], however, no additional study has been reported. We evaluate the clinical availability of Endoclips for the management of small GI perforations. Material and Methods: A total 5 patients with GI perforations following endoscopic procedures were included in this study. The diseases of patients are flat adenoma of stomach 1 case, early gastric cancer 1 case, GIST(gastrointestinal stromal tumor) 2 cases and early colon cancer 1 case. Therapeutic endoscopic procedures causing GI perforations were either endoscopic mucosal resection or incisional enucleation. Endoscopy was performed for closing the perforation using metallic clips(MD 850, Olympus Corp.) and clip delivery catheters(HX-3L, HX-5LR-1, Olympus Corp.) Results: Diagnosis Location Age Sex Size (cm) Procedure Result EGC body, post. wall 75 F 2.5 × 1.3 EMR success GIST fundus 59 F 1.3 × 1.2 IE success GIST fundus 56 F 3.3 × 3.0 IE success Flat adenoma body, ant. wall 66 M 2.3 × 1.7 EMR success ECC sig. colon 55 F 2.1 × 1.1 EMR success EMR: endoscopic mucosal resection IE: incisional enucleation No complication secondary to clipping occured. Follow up endoscopy showed complete healing, with scar. Conclusions: Endoclips can be applicated to close small GI perforations and thus may help to avoid surgery.",
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AU - Chun, Hoon-Jai

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AU - Kim, K. H.

AU - Park, H. J.

AU - Um, Soon-Ho

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AU - Kim, Chang Duck

AU - Ryu, H. S.

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