出血性胃十二指腸潰瘍に対するショートクリップの使用経験  [in Japanese] ENDOSCOPIC SHORT CLIP HEMOSTASIS IN BLEEDING GASTRODUODENAL ULCERS  [in Japanese]

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Abstract

今回われわれは出血性胃十二指腸潰瘍に対しショートクリップ(オリンバス社製HX600135S)による止血術を試みた.ショートクリップは従来の止血用クリップ(同社製HX600 135)に比べ組織把持部分が約2mm短いため,クリップ先端が潰瘍底を滑りにくく露出血管の結紮がこれまでより確実に行える.クリップが掛かりづらい接線方向の病変に対しては先端突出長4mmの軟性透明フードを併用し正面方向からアブローチした.対象の出血性胃十二指腸潰瘍12例全例で初回完全止血に成功し再出血は認められなかった.用いたクリップの個数は1~3個(平均2.2個)で,出血点を発見してから治療終了までに要した時間は何れも15分以内であった.治療に伴う潰瘍の拡大や合併症も認められなかった.ショートクリップは従来の止血用クリップに比べ組織把持部分が短くなったことで露出血管まを確実に結紮できるようになり止血効果に優れていると考えられた.

We have performed endoscopic treatment of bleeding from gastric and duodenal tllcersusing short clips:HX-600-135S(Olympus Optical Co.). The short clip, HX-600-135S, is 2mmshorter in length of arms than the conventional hemoclip, HX-600-135(Olyrnpus), so that a'vissible vessel in the base of ulcer can be clarnped surely and tightly. This short clip therapywas used in12 patients inclu.dzng 9 with hemorrhagic gastric ulcer end 3 with hemorrhagicduodellal ulcer. When tallgα1tial approach was needea, it was technically more difficult toapply short clips to the vissible vessel, so we attached a soft transparellt hood(disposabledistant attachment)on the tip of a endoscope to take the endoscopic frolltal view of the lesior1.In all the patients, the initial session achieved permanent hemostasis and there was no episodeof recurrent bleeding. The:number of short clips required for hemostasis ranged from l to 3(mean 2.2), and the times taken for treatment from discovery of a bleeding point to achivehemostasis were within 15 minutes in all cases. This therapy did rlot enlarg the area ofulceration, and no complication associated with treatment had occurred. This study suggestedthat the arms of a short clip are so shorter than those of a conventional hemoclip that a vissiblevessel in the base of ulcer can be grasped completely and that the short clip method is quiteeffective for hemostasis of bleeding gastroduodenal ulcers.

Journal

  • GASTROENTEROLOGICAL ENDOSCOPY

    GASTROENTEROLOGICAL ENDOSCOPY 44(2), 176-182, 2002-02-20

    Japan Gastroenterological Endoscopy Society

References:  13

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008361744
  • NII NACSIS-CAT ID (NCID)
    AN00192102
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03871207
  • Data Source
    CJP  CJPref  J-STAGE 
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