Abstract
Endoscopic haemostasis by means of haemostatic clips is in particular in the upper part of the GIT an effective and successful method. The objective of the work was to analyze on a one-year sample of clipped patients the success of haemostasis, percentage of relapses of haemorrhage and mortality of treated patients, to analyze in more detail the lesions and at which level of the GIT they were clipped, and last not least, to analyze the relationship of mortality and the patients' age and sex.
The group comprised 46 haemostases in 45 patients, on average 3 clips per patient were used. The mean age of the treated patients was 64.5 years.
The success rate of haemostasis was 96%, in 4% it did not prove possible to arrest haemorrhage by means of clips, in 17% an early relapse of haemorrhage occurred. Two patients where the haemorrhage could not be arrested had a surgical revision, one of them died.
Of 8 patients where a relapse of haemorrhage occurred in 4 it was arterial haemorrhage from a gastric ulcer, all 4 died from complications of haemorrhage. In 3 patients a relapse occurred after clipping of the arterial haemorrhage from ulceration of the duodenal bulb, all were operated on account of the relapse, 2 survived.
One patient died as a result of a relapse of haemorrhage from an ulcer in the distal oesophagus. The mean age of the treated men was 60 years, of the women 72 years.
The group comprised two thirds of men and one third of women. All patients where it did not prove possible to arrest the haemorrhage or who had a relapse and survived were operated.
Clips were used most frequently in the stomach and duodenal bulb, as to lesions most frequently the blood vessel at the bottom of the ulceration was clipped. The authors' assembled results confirm the great effectiveness of haemostatic clips in primary haemostasis in the GIT and are in keeping with data reported in the world literature.