title: Endoscopic hemoclipping using a transparent cap in technically difficult cases.
abstract: OBJECTIVE
  Technical difficulties have been experienced in endoscopic hemoclipping on the posterior wall of the body of the stomach because the angle of approach is tangential. It has been suggested that the use of a transparent cap on the tip of the endoscope could help to solve this problem. The purpose of this study was to examine the efficacy of endoscopic hemoclipping using a transparent cap over the tip of the endoscope.
  
  
  METHODS
  A total of 74 patients with a bleeding peptic ulcer or stigmata of recent hemorrhage underwent endoscopic hemoclipping. Technical difficulty in hemoclipping was experienced in 18 patients and the transparent cap was used in these cases. We therefore conducted a nonrandomized prospective study to compare bleeding control with the hemoclip with and without the aid of a transparent cap.
  
  
  RESULTS
  There were no statistically significant differences between the patients treated with the cap and those treated without the cap with regard to the initial hemostasis rate (94.4 % vs. 91.1 %), the rebleeding rate (11.7 % vs. 11.8 %), or the permanent hemostasis rate (94.4 % vs. 96.4 %).
  
  
  CONCLUSIONS
  Although there was no statistically significant difference between patients treated with or without a transparent cap, hemoclipping with the aid of the cap made it possible to clip a lesion too tangential to be clipped without it. However, this study did not compare conventional hemoclipping with hemoclipping using a cap because the cap was only used in cases in which conventional clipping had failed.
authors.affiliation: Department of Gastroenterology, Internal Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: J I
authors.initials: JI
authors.lastname: Kim
authors.forename: S S
authors.initials: SS
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.forename: J
authors.initials: J
authors.lastname: Han
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
authors.forename: S W
authors.initials: SW
authors.lastname: Han
authors.forename: K Y
authors.initials: KY
authors.lastname: Choi
authors.forename: I S
authors.initials: IS
authors.lastname: Chung
authors.forename: K W
authors.initials: KW
authors.lastname: Chung
authors.forename: H S
authors.initials: HS
authors.lastname: Sun
mesh_terms: D004381:Duodenal Ulcer / Q000150:complications* / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D016558:Hemostasis, Endoscopic / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology* / Q000601:surgery*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome