Right tool for the right bleeder

We read with great interest the study by Chan et al1 and would like to commend the group’s findings that use of over-the-scope clip (OTSC) as primary haemostasis in large peptic ulcers, compared with standard therapy, was not associated with a significant decrease in 30-day rebleeding. Currently, minimising rebleeding risk of peptic ulcers remains a challenge for endoscopists. Factors predicting the risk of rebleeding include underlying patient comorbidities, active bleeding, ulcer size, ulcer location,2 operator experience and capability of different devices.3 The study was well conducted, however, there are certain nuances that we feel would add strength to the findings. First, baseline scoring systems currently used in clinical practice can aid in risk stratification of rebleeding risk, such as the Rockall Score or Glasgow-Blatchford Score.4 Subgroup analyses with these scores may aid us to identify a higher risk group that would...

Source: Gut - December 7, 2023 Category: Gastroenterology Authors: Toh, D. E., Lo, S. W., Tsoi, A., Segal, J. P., Butt, J. Tags: Gut PostScript Source Type: research