Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery  

作　　者：Zhen-Zhen Wang Xian-Bin Zhou Yi Wang Xin-Li Mao Li-Ping Ye Ling-Ling Yan Ya-Hong Chen Ya-Qi Song Yue Cai Shi-Wen Xu Shao-Wei Li 

机构地区：[1]Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,Zhejiang Province,China [2]Department of Gastroenterology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,Zhejiang Province,China [3]Health Management Center,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,Zhejiang Province,China [4]Taizhou Hospital of Zhejiang Province,Wenzhou Medical University,Linhai 317000,Zhejiang Province,China

出　　处：《World Journal of Gastroenterology》2021年第35期5958-5966,共9页世界胃肠病学杂志（英文版）

基　　金：Supported by Program of Taizhou Science and Technology Grant,No.20ywb29;Medical Health Science and Technology Project of Zhejiang Province,No.2021PY083 and No.2019KY239;Key Technology Research and Development Program of Zhejiang Province,No.2019C03040;Major Research Program of Taizhou Enze Medical Center Grant,No.19EZZDA2;Open Fund of Key Laboratory of Key Laboratory of Minimally Invasive Techniques&Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province,No.21SZDSYS01 and No.21SZDSYS09。

摘　　要：BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.AIM To evaluate the effectiveness and safety of an over-the-scope clip(OTSC)in the treatment of perforation post-endoscopic resection of duodenal SELs.METHODS From May 2015 to November 2019,18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs.Data comprising the rate of complete resection,closure of intraprocedural perforation,delayed bleeding,delayed perforation,and postoperative infection were extracted.RESULTS The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%.The median perforation size was 1 cm in diameter.Seventeen patients had minor intraoperative bleeding,while the remaining 1 patient had considerable amount of bleeding during the procedure.Seven patients had postoperative abdominal infections,of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock.All 18 patients recovered and were discharged.No delayed bleeding or perforation was reported.The mean time taken to resume normal diet after the procedure was 6.5 d.The mean postoperative hospital stay was 9.5 d.No residual or recurrent lesions were detected during the follow-up period(15-66 mo).CONCLUSION Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.

关 键 词：Over-the-scope clip Duodenal subepithelial lesion Endoscopic resection Perforation EFFECTIVENESS SAFETY 

分 类 号：R656.64[医药卫生—外科学]