Over-the-scope clip as first-line therapy for ulcers with high-risk bleeding stigmata is efficient compared to standard endoscopic therapy.

Discussion Our comparative study results demonstrate a high rate of success in attaining hemostasis with OTSC as first-line endoscopic therapy for ulcers with high-risk stigmata compared to the standard endoscopic therapy, but this difference did not reach statistical significance, likely due to smaller sample size.

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