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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(04): 279-282
DOI: 10.1055/s-0040-1722387
Research Article

Endoscopic Treatment of Upper Gastrointestinal Bleeding Using Haemoseal Spray: A Retrospective, Observational Study from a Tertiary Center in North India

Rinkesh Kumar Bansal
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Mahesh Kumar Gupta
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Varun Kumar Gupta
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Gursimran Kaur
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Avnish Kumar Seth
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
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Abstract

Introduction United States Food and Drug Administration recently approved use of Hemospray for the management of gastrointestinal (GI) Bleeding. We report our experience with Haemoseal Spray (HS, Shaili Endoscopy) for the treatment of upper GI bleeding (UGIB).

Methods Records of patients who received HS for UGIB from January 2013 to June 2018 were studied retrospectively. Patients with UGIB from focal lesions refractory to conventional endotherapy or those with diffuse/multiple lesions not amenable to conventional endotherapy received 5cc HS spray. Primary end-point studied was clinical success, defined as control of bleeding over 24 hours. Secondary end-points evaluated included recurrence of bleeding within 7 days, in-hospital mortality, and complications secondary to HS.

Results Thirty-eight patients were treated with HS. The median age was 57 (range: 5–87) years with 27 males and 11 females. In 24 patients, HS was used as monotherapy, while it was combined with Injection/Clip/Argon Plasma Coagulation in 14. Etiology of bleeding was ulcers or erosions in 22, malignancy in 10, portal hypertensive gastropathy/gastric antral vascular ectasia in 4, and radiation gastropathy in 2. Clinical success was achieved in 32/38 (84%). All six nonresponders had coagulopathy related to chemotherapy/bone marrow transplant. Recurrent bleeding within 7 days was observed in four patients (gastric malignancy 2, radiation gastropathy 2). In-hospital mortality was seen in 8/38 (21%) of which 2(4.8%) were directly related to ongoing GI bleeding. There was no procedure-related complication.

Conclusion HS is an effective and safe tool in the endoscopic management of UGIB due to diffuse or multiple focal lesions or focal lesions refractory to conventional endotherapy.

Keywords

endoscopic treatment - Haemoseal Spray - upper GI bleeding


Publication History

Article published online:
31 December 2020

© 2020. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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