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Background: To compare the clinical outcomes in patients with acute perforated peptic ulcer (PPU) treated with over-the-scope clip (OTSC), non-surgical, and surgical interventions, and to explore the effectiveness and safety of OTSC closure. Methods: Hospital stay, antibiotic use, diet resumption time, and mortality rate were analyzed retrospectively. Binary Logistic regression analysis was used to identify the risk factors influencing PPU complicated with sepsis. Results: Patients were divided into three treatment groups: OTSC (n = 62), non-surgical (n = 72), and surgical (n = 55) groups. The median time (IQR) from symptom onset to admission was 9.0 (4–23) h. 88.71% (55/62) of the patients in In the OTSC group underwent OTSC closure within 24 h (median [IQR] time: 14.5 [7.00–30.25] h). The perforation diameters in the OTSC and surgical groups were 9.87 mm ± 5.97 mm and 8.55 mm ± 6.17 mm, respectively. The median (IQR) hospital stays in the OTSC (9.50 [7.00–12.25] days) and non-surgical group (9.00[7.00–13.00]days) were similar (p > 0.05), but shorter than that in surgical group (12.00[10.00–16.00]days), (p < 0.05). The median duration of antibiotic use was shorter in the OTSC group (7.00[3.00–10.00]) than in the non-surgical group (9.00[7.00–11.00]) and surgical group (11.00[9.00–13.00]) (p < 0.05); and the time to resume oral feeding was shorter in the OTSC group (4.00[2.00–5.25]) than in the non-surgical group (7.00[6.13–9.00]) and surgical group (8.00[6.53–10.00]), respectively (p < 0.05). No mortality difference among groups (p = 0.109) was found. Lower albumin level at admission, older age, and elevated creatinine levels were associated with increased sepsis risk, with OR(95%CI) of 0.826 (0.687–0.993), 1.077 (1.005–1.154), and 1.025 (1.006–1.043), respectively (all p < 0.05). Conclusion: OTSC closure improves clinical outcomes of acute PPU patients without sepsis. Age, hypoalbuminemia, and baseline renal dysfunction increase the risk of sepsis, while mortality was associated with sepsis and multiorgan dysfunction. [ABSTRACT FROM AUTHOR]

Keywords: endoscopy; gastrostomy; enteral nutrition; indications; complications EN endoscopy gastrostomy enteral nutrition indications complications 733 741 9 05/11/22 20220401 NES 220401 Introduction Compared to parenteral nutrition, enteral nutrition helps to maintain mucosal barrier protection,[1] as well as improve the immunology and nutritional status of patients.[2] Tube feeding can be considered for patients with poor oral intake due to various reasons such as neurological disorders, dysphagia, etc. For patients with advanced tumors or patients who can not receive sufficient oral intake for other reasons, if their nutritional status can be improved by gastrostomy, their quality of life will be greatly improved. A nasogastric tube is mainly used for temporary enteral feeding (< 4 weeks), while various gastrostomy and enterostomy techniques are used for long-term enteral feeding (> 4 weeks).[3] Currently, percutaneous endoscopic gastrostomy (PEG) is the most widely used technique for the establishment of long-term tube feeding access. After stratifying patients with malignant tumors according to their tumor location, it was found that the complication rates of the two groups were similar in patients with head, neck and esophageal cancer (P = 0.648 and P = 0.052). [Extracted from the article]