Usefulness of wide-channel endoscope for the management of upper gastrointestinal hemorrhage in emergency esophagogastroduodenoscopy (EGD)

Massive blood clots and food debris sometimes hamper emergency EGD for upper gastrointestinal hemorrhage by preventing clear endoscopic view resulting in difficulty in identification of the source of bleeding. Handling the difficulty with standard endoscopes by adjuvant techniques is often time consuming. We had an opportunity to use a new wide-channel endoscope (GIF XT-30, Olympus, Tokyo). GIF XT-30 has a wide forceps-channel with a diameter of 6 mm. The outer diameter at the distal end is 13.7 mm. A three-way stopcock connected to the channel enables the use of a double suction system with this scope. To clarify the efficacy and feasibility, we measured the time for suction of 500ml of distilled water and 100ml of plain yogurt with GIF XT-30 and GIF Q240 having a channel 2.8 mm in diameter (Olympus, Tokyo). The times required for sucking water and yogurt were signifficantly shorter by GIF XT-30 than those by GIF Q240. In clinical practice during six months period, GIF XT -30 was applied for 22 cases (11.3%) among 194 emergency EGDs. Suction of massive blood clots and food debris was successful and optimal endoscopic view was obtained in 19 of 22 cases. We conclued that GIF XT-30 is excellent in sucking massive clots and food debris and shortens the time of emergency EGD. This endoscope is an indispensable item for major endoscopic centers perfoming large volume emergency endoscopy.