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Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report
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Sun Young Moon, Min Kyu Jung, Jun Heo
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Clin Endosc 2022;55(3):443-446. Published online May 25, 2021
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DOI: https://doi.org/10.5946/ce.2020.294
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Abstract
PDFPubReaderePub
- Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.
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Citations
Citations to this article as recorded by
- Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee Gut and Liver.2024; 18(1): 10. CrossRef - Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee Clinical Endoscopy.2023; 56(4): 391. CrossRef - Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
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Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding
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Sun Young Moon, Jun Heo, Min Kyu Jung, Chang Min Cho
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Clin Endosc 2022;55(1):128-135. Published online May 25, 2021
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DOI: https://doi.org/10.5946/ce.2021.057
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Abstract
PDFPubReaderePub
- Background
/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding.
Methods Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis.
Results A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min.
Conclusions Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.
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The Clinical Significance and Management of Noncurative Endoscopic Resection in Early Gastric Cancer
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Jun Heo, Seong Woo Jeon
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Clin Endosc 2013;46(3):235-238. Published online May 31, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.3.235
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Abstract
PDFPubReaderePub
Nowadays, endoscopic mucosal resection or endoscopic submucosal dissection has shown effectiveness equivalent to that of gastrectomy and has emerged as a popular technique for curative treatment of gastric cancer. However, noncurative resection or resection beyond the indication may lead to lymphatic and extended organ metastasis resulting in loss of the opportunity for full recovery. Therefore, it is an important issue to decide the range of curative resection in the endoscopic resection field. Furthermore, management of noncurative endoscopic resection in early gastric cancer is also important. The most favorable treatment after noncurative resection would be surgery. However, other noninvasive treatments such as argon plasma coagulation, additional endoscopic resection and close observation for recurrence are thought to be the optional treatments after the noncurative resection. In the future, prospective research studies and observations are expected to verify the effectiveness of noninvasive treatments.
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Citations
Citations to this article as recorded by
- Improved pentamethine cyanine nanosensors for optoacoustic imaging of pancreatic cancer
Matthew D. Laramie, Benjamin L. Fouts, William M. MacCuaig, Emmanuel Buabeng, Meredith A. Jones, Priyabrata Mukherjee, Bahareh Behkam, Lacey R. McNally, Maged Henary Scientific Reports.2021;[Epub] CrossRef - Additional laparoscopic gastrectomy after noncurative endoscopic submucosal dissection for early gastric cancer: A single-center experience
Yan-Tao Tian, Fu-Hai Ma, Gui-Qi Wang, Yue-Ming Zhang, Li-Zhou Dou, Yi-Bin Xie, Yu-Xin Zhong, Ying-Tai Chen, Quan Xu, Dong-Bing Zhao World Journal of Gastroenterology.2019; 25(29): 3996. CrossRef - Risk stratification and management of non-curative resection after endoscopic submucosal dissection for early gastric cancer
Jae Pil Han, Su Jin Hong, Hee Kyung Kim, Yun Nah Lee, Tae Hee Lee, Bong Min Ko, Joo Young Cho Surgical Endoscopy.2016; 30(1): 184. CrossRef - Additional Gastrectomy after Non-Curative Endoscopic Submucosal Dissection for Early Gastric Cancer
Yeon Soo Chang The Journal of Minimally Invasive Surgery.2016; 19(1): 3. CrossRef - Highlights of the 48th Seminar of Korean Society of Gastrointestinal Endoscopy
Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm Clinical Endoscopy.2013; 46(3): 203. CrossRef
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