Evaluating the Significance of Titanium Clip Marking Under Endoscopy in Upper Gastrointestinal Bleeding Patients with Failed Endoscopic Hemostasis.

ABSTRACT

Objective: This study investigated the role of titanium clip marking during endoscopy in managing patients with upper gastrointestinal bleeding (UGIB) for whom endoscopic hemostasis has proven ineffective. Methods: A total of 63 UGIB patients admitted to the Affiliated Hospital of Zunyi Medical University between January 2018 and November 2020 were selected as the study cohort. Patients were randomly assigned to one of two groups the control group (n=23) and the combined group (n=40). The control group underwent transcatheter arterial embolization (TAE), while the combined group received endoscopic metallic titanium clip-assisted TAE. This study compared the rates of successful embolization, clinical success, recurrence, operation time, radiation exposure time, radiation dosage, levels of hs-CRP, Cor, NE, TNF-α, IL-6, and ADH before and after treatment, as well as postoperative complications between the two groups. Results: The combined group of patients exhibited significantly higher rates of successful embolization and clinical success compared to the control group (P < .05). Additionally, the recurrence rate and levels of hs-CRP, Cor, NE, TNF-α, IL-6, and ADH were significantly lower in the combined group compared to the control group (P < .05). Furthermore, patients in the combined group had shorter operation times, reduced radiation exposure times, and lower radiation dosages compared to the control group (P < .05). There was no statistically significant difference in the occurrence of postoperative complications between the two groups (P > .05). Conclusions: Using titanium clip marking during endoscopy provides valuable guidance in managing patients with upper gastrointestinal bleeding who have not responded to endoscopic hemostasis. This finding is especially relevant in digital subtraction angiography (DSA) and transcatheter arterial embolization (TAE) treatments. It enhances the clinical efficacy and safety of the procedure.