Küçükdemirci Ö, Ayyildiz T, Bas B, Eruzun H, Efe N, Bektas A. Endoscopic transparent cap assisted hemostasis: A multicenter retrospective cohort study. World J Gastroenterol 2026; 32(15): 116083 [DOI: 10.3748/wjg.v32.i15.116083]
Corresponding Author of This Article
Ömer Küçükdemirci, MD, Chief Physician, Department of Gastroenterology, Hakkari State Hospital, Dağgöl, Gençlik Cd. No:2, 30000 Hakkâri Merkez/Hakkari, Hakkari 30000, Türkiye. drkucukdemirci@yahoo.com
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Gastroenterology & Hepatology
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Retrospective Cohort Study
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Apr 21, 2026 (publication date) through Apr 15, 2026
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World Journal of Gastroenterology
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1007-9327
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Küçükdemirci Ö, Ayyildiz T, Bas B, Eruzun H, Efe N, Bektas A. Endoscopic transparent cap assisted hemostasis: A multicenter retrospective cohort study. World J Gastroenterol 2026; 32(15): 116083 [DOI: 10.3748/wjg.v32.i15.116083]
World J Gastroenterol. Apr 21, 2026; 32(15): 116083 Published online Apr 21, 2026. doi: 10.3748/wjg.v32.i15.116083
Endoscopic transparent cap assisted hemostasis: A multicenter retrospective cohort study
Ömer Küçükdemirci, Talat Ayyildiz, Berk Bas, Hasan Eruzun, Nisa Efe, Ahmet Bektas
Ömer Küçükdemirci, Department of Gastroenterology, Hakkari State Hospital, Hakkari 30000, Türkiye
Talat Ayyildiz, Ahmet Bektas, Faculty of Medicine, Department of Gastroenterology, Ondokuz Mayis University, Samsun 55139, Türkiye
Berk Bas, Faculty of Medicine, Department of Gastroenterology, Aydın Adnan Menderes University, Aydın 09000, Türkiye
Hasan Eruzun, Department of Gastroenterology, Samsun Training and Research Hospital, Samsun 55200, Türkiye
Nisa Efe, Department of Internal Medicine, Gaziantep City Hospital, Gaziantep 27470, Türkiye
Author contributions: Küçükdemirci Ö made substantial contributions to the conception and design of the study, data acquisition, analysis, and interpretation, drafted the manuscript and made critical revisions for important intellectual content; Ayyildiz T and Bektas A contributed to critical revision of the manuscript and interpretation of data; Bas B, Eruzun H, and Efe N participated in data collection and provided clinical data support; all authors read and approved the final version of the manuscript and agree to be accountable for all aspects of the work.
Institutional review board statement: Approved by the Ondokuz Mayıs University Ethics Committee (approval No. 2024000168-2), permissions obtained from all participating centers.
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Data are available from the corresponding author upon reasonable request, subject to ethical, legal, and patient confidentiality requirements.
Corresponding author: Ömer Küçükdemirci, MD, Chief Physician, Department of Gastroenterology, Hakkari State Hospital, Dağgöl, Gençlik Cd. No:2, 30000 Hakkâri Merkez/Hakkari, Hakkari 30000, Türkiye. drkucukdemirci@yahoo.com
Received: November 3, 2025 Revised: December 4, 2025 Accepted: February 3, 2026 Published online: April 21, 2026 Processing time: 164 Days and 12 Hours
Abstract
BACKGROUND
Non-variceal upper gastrointestinal bleeding (NVUGIB) remains a common and potentially life-threatening emergency despite advances in endoscopic therapy. Endoscopic transparent caps (CAPs) have been proposed to enhance lesion visualization and procedural stability, but their effect on clinical outcomes is uncertain.
AIM
To evaluate whether CAP use during therapeutic endoscopy influences hemostatic efficacy and short-term outcomes in NVUGIB.
METHODS
A total of 206 patients who underwent emergency endoscopic hemostasis between 2021 and 2025 at six tertiary centers in Türkiye were included. Patients were divided into CAP-assisted (n = 67) and non-CAP (n = 139) groups. Baseline characteristics, comorbidities, Glasgow-Blatchford and Rockall scores, hemostatic methods, and clinical outcomes were analyzed. Multivariable linear regression identified independent predictors of post-admission transfusion requirement and hospital length of stay (LOS).
RESULTS
Baseline demographic and clinical variables were comparable between groups. CAP was more often used in hemodynamically unstable patients. The CAP group required a greater number of hemostatic techniques (2.66 ± 1.00 vs 2.14 ± 0.87; P < 0.001), with higher use of Ankaferd Blood Stopper and argon plasma coagulation, but received fewer post-admission transfusions (14.8 % vs 33.8 %; P = 0.006) and a lower transfusion volume (0.44 ± 1.13 U vs 0.91 ± 1.31 U; P = 0.012). Mortality, intensive-care need, and LOS did not differ significantly. CAP use independently predicted reduced transfusion volume (β = -0.47, P = 0.010), whereas higher Charlson Comorbidity index and intensive care unit admission predicted longer LOS.
CONCLUSION
CAP-assisted endoscopy may improve procedural efficiency and hemostatic control in NVUGIB, reducing transfusion requirements without affecting mortality or hospitalization. Prospective randomized trials are warranted to validate these findings and clarify CAP’s role in standardized bleeding management.
Core Tip: This multicenter retrospective study compared transparent cap (CAP)-assisted and standard endoscopic hemostasis in non-variceal upper gastrointestinal bleeding (NVUGIB). CAP was used more often in hemodynamically unstable patients and required a greater number of hemostatic techniques but was associated with lower post-admission transfusion rates and volumes. Mortality and hospital stay were comparable between groups. CAP assistance may enhance procedural precision and efficiency without altering systemic outcomes, representing a simple and inexpensive adjunct for improving endoscopic management of NVUGIB.
