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. 2016:2016:9371878.
doi: 10.1155/2016/9371878. Epub 2016 May 16.

Efficacy of the Ovesco Clip for Closure of Endoscope Related Perforations

Phonthep Angsuwatcharakon  1 , Piyapan Prueksapanich  2 , Pradermchai Kongkam  2 , Thawee Rattanachu-Ek  3 , Jaksin Sottisuporn  4 , Rungsun Rerknimitr  2
Affiliations

Efficacy of the Ovesco Clip for Closure of Endoscope Related Perforations

Phonthep Angsuwatcharakon et al. Diagn Ther Endosc. 2016.

Abstract

Aim. To study the efficacy and other treatment outcomes of Ovesco clip closure of iatrogenic perforation. Methods. Retrospective study from 3 tertiary-care hospitals in Thailand. Patients with iatrogenic perforation who underwent immediate endoscopic closure by Ovesco clip were included. Patients' demographic data, perforation size, number of Ovesco clips used, fasting day, length of hospital stay, success rates, and complication rate were recorded. Technical success was defined as closure achievement during endoscopic procedure and clinical success was defined as the patient can be discharged without the need of additional surgical or radiological intervention. Results. There were 6 iatrogenic perforations in 2 male and 4 female patients. The median age was 59 years (range 39-78 years). The locations of perforation were 5 duodenal walls and 1 rectosigmoid junction. The median perforation size was 13 mm (range 10-40 mm). The technical success was 100% and the clinical success was 83.3%. The success rates per locations were 100% in colon and 80% in duodenum, respectively. The median fasting time was 5 days (range 1-10 days) and the median length of hospital stay was 10 days (range 2-22 days). There was no mortality in any. Conclusion. Ovesco clip seems to be an effective and safe tool for a closure of iatrogenic perforation.

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Figures

Figure 1
Figure 1
Endoscopic pictures of patients with successful closure by one Ovesco clip. (a) Rectosigmoid perforation; (b) after Ovesco clip closure of rectosigmoid perforation; (c) medial duodenal wall perforation; (d) after Ovesco clip closure of medial duodenal wall perforation; (e, g, i) lateral duodenal wall perforations; (f, h, j) after Ovesco clip closure of lateral duodenal wall perforations.
Figure 2
Figure 2
A case with 40 mm perforation at duodenal wall. (a) Two Ovesco clips with omental patch were applied; (b) enterogram revealed persistent contrast leakage indicating an incomplete closure.
Figure 3
Figure 3
Rescue band ligation after 2 Ovesco clips' application. (a) A residual perforation was detected; (b) successful closure with an additional band ligation.
See this image and copyright information in PMC

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