ArticleUnited European gastroenterology journal2022
Endoscopic direct clipping versus indirect clipping for colonic diverticular bleeding: A large multicenter cohort study.
Article in United European gastroenterology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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Who cites it
21 citing papers in PubMed, 28 citations in OpenAlex.
- Article
- Prevention of Rebleeding in Colonic Diverticular Bleeding Using Orengedokuto: Protocol for a Double-Blind Randomized Controlled Trial.JMIR research protocols · 2026Article
- Small-caliber cap-assisted identification of an exposed vessel and direct clipping for colonic diverticular bleeding.Endoscopy · 2026Article
- Underwater indirect clipping for colonic diverticular bleeding.Endoscopy · 2026Article
- Updated evidence on epidemiology, diagnosis, and treatment for colonic diverticular bleeding.DEN open · 2026Review
- Minimum colonoscopy observation time for colonic diverticular bleeding: A new benchmark based on the 5% plateau time.World journal of gastroenterology · 2025Article
- Endoscopic treatment modalities for colonic diverticular bleeding: A systematic review with direct and network meta-analyses.World journal of gastrointestinal endoscopy · 2025Article
- Direct observation of an exposed blood vessel in a colonic diverticulum using ultrathin endoscopy.DEN open · 2025Article
- Article
- Look inside the management of colonic diverticular rebleeding: a systematic review.Therapeutic advances in gastroenterology · 2025Review
- Endoscopic band ligation alone and combined with clipping for colonic diverticular bleeding: Retrospective comparative study.Endoscopy international open · 2025Article
- Useful treatment selection strategy for endoscopic hemostasis in colonic diverticular bleeding according to endoscopic findings (with video).Endoscopy international open · 2025Article
- Direct Clipping for Active Colonic Diverticular Bleeding Using an Endoclip with Re-grasping Function.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Article
- Usefulness of a long hood for the detection of bleeding sites in colonic diverticular hemorrhage: A randomized controlled trial.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Trends and Changes in Endoscopic Management and Clinical Outcomes of Colonic Diverticular Bleeding during the Coronavirus Disease-2019 Pandemic.Journal of the anus, rectum and colon · 2024Article
- A Review of Colonoscopy in Intestinal Diseases.Diagnostics (Basel, Switzerland) · 2023Review
- LONG-HOSP Score: A Novel Predictive Score for Length of Hospital Stay in Acute Lower Gastrointestinal Bleeding - A Multicenter Nationwide Study.Digestion · 2023Article
- Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding.Journal of clinical medicine · 2022Article
- A new band ligation device to treat colonic diverticular bleeding.Clinical endoscopy · 2022Article
- Endoscopic direct clipping versus indirect clipping for colonic diverticular bleeding: A large multicenter cohort study.United European gastroenterology journal · 2022Article
Corrections and comments
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Authors and funding
45 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect and indirect clipping treatments are used worldwide to treat colonic diverticular bleeding (CDB), but their effectiveness has not been examined in multicenter studies with more than 100 cases.
objectiveWe sought to determine the short- and long-term effectiveness of direct versus indirect clipping for CDB in a nationwide cohort.
methodsWe studied 1041 patients with CDB who underwent direct clipping (n = 360) or indirect clipping (n = 681) at 49 hospitals across Japan (CODE BLUE-J Study).
resultsMultivariate analysis adjusted for age, sex, and important confounding factors revealed that, compared with indirect clipping, direct clipping was independently associated with reduced risk of early rebleeding (<30 days; adjusted odds ratio [AOR] 0.592, p = 0.002), late rebleeding (<1 year; AOR 0.707, p = 0.018), and blood transfusion requirement (AOR 0.741, p = 0.047). No significant difference in initial hemostasis rates was observed between the two groups. Propensity-score matching to balance baseline characteristics also showed significant reductions in the early and late rebleeding rates with direct clipping. In subgroup analysis, direct clipping was associated with significantly lower rates of early and late rebleeding and blood transfusion need in cases of stigmata of recent hemorrhage with non-active bleeding on colonoscopy, right-sided diverticula, and early colonoscopy, but not with active bleeding on colonoscopy, left-sided diverticula, or elective colonoscopy.
conclusionsOur large nationwide study highlights the use of direct clipping for CDB treatment whenever possible. Differences in bleeding pattern and colonic location can also be considered when deciding which clipping options to use.
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