Post written by Feifan Chen, MD, Yifan Jia, MD, and Xue Xiao, MD, PhD, from West China Hospital of Sichuan University, Chengdu, China.

We retrospectively collected data from 3 hospitals from patients who underwent endoscopic hemostasis for nonvariceal GI bleeding (GIB). Overall, 36 refractory bleeding patients received endoscopic purse-string sutures (PSSs), and 83.3% of them achieved clinical success. In refractory upper GIB, the clinical success rate was 81.25% and, in lower GIB, the clinical success rate was 100%.

The PSS is initially used in endoscopic submucosal dissection or EMR to close the postoperative lesion. We found it could achieve hemostasis in large ulcers, especially in refractory bleeding cases with an unhealed ulcer. We considered that PSSs might be an alternative treatment for refractory nonvariceal GIB; therefore, this study was conducted.

Studies show an over-the-scope clip (OTSC) is effective therapy for refractory bleeding, and it could close an ulcer of up to 2 cm. However, it is expensive and unavailable in some areas or centers. The procedure of PSSs needs clips and nylon rope, which are inexpensive and common at most centers.

Moreover, with no lesion size limitation for PSSs, lesions >2 cm that an OTSC could not treat might be treated with PSSs. Still, our study is retrospective and observational. A prospective study to compare the OTSC and PSS is needed.

Endoscopic views before and after the use of purse-string sutures.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.