title: Clinical evaluation of emergency endoscopic hemostasis with bipolar forceps in non-variceal upper gastrointestinal bleeding.
abstract: The present study was designed to evaluate the usefulness and safety of bipolar hemostatic forceps, known as a less invasive and highly safe means of thermal coagulation used for hemostasis in cases of non-variceal upper gastrointestinal bleeding. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis. The study involved 39 cases where hemostasis was attempted with bipolar forceps to deal with non-variceal upper gastrointestinal bleeding, including 28 cases of gastric ulcer, six cases of duodenal ulcer, three cases of bleeding after endoscopic submucosal dissection (ESD), one case of Mallory-Weiss syndrome and one case of postoperative bleeding from the anastomosed area. There were 34 males and five females, with a mean age of 63.6 years. Bipolar forceps were the first-line means of hemostasis in cases of oozing bleeding (venous bleeding), pulsatile or spurting bleeding (arterial bleeding) and exposed vessels without active bleeding. The primary hemostasis success rate was 92.3%, and the re-bleeding rate was 0%. In cases where the bleeding site was located along the tangential line or in cases where large respiration-caused motions hampered identification of the bleeding site, hemostasis by means of coagulation was easily effected by application of electricity while the forceps were kept open and compressed the bleeding area. In addition, there were no complications. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Shinjyuku-ku, Japan. mikinori@tokyo-med.ac.jp <mikinori@tokyo-med.ac.jp>
authors.forename: Mikinori
authors.initials: M
authors.lastname: Kataoka
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Kenji
authors.initials: K
authors.lastname: Yagi
authors.forename: Chizuko
authors.initials: C
authors.lastname: Tachibana
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tachibana
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Hayama
authors.forename: Kei
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Masaya
authors.initials: M
authors.lastname: Nonaka
authors.forename: Takaya
authors.initials: T
authors.lastname: Aoki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Oshima
authors.forename: Mari
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Mari
authors.initials: M
authors.lastname: Fukuzawa
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Fukuzawa
authors.forename: Kouhei
authors.initials: K
authors.lastname: Kawakami
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakai
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract