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Zhu WW, Chen XL, Yang Z, Han K, Jia W. Endoscopic hemostatic powder spray: Current evidence and clinical applications. World J Gastrointest Endosc 2026; 18(11): 126270 [DOI: 10.4253/wjge.126270]
World J Gastrointest Endosc. Nov 16, 2026; 18(11): 126270 Published online Nov 16, 2026. doi: 10.4253/wjge.126270
Endoscopic hemostatic powder spray: Current evidence and clinical applications
Wen-Wen Zhu, Xu-Lin Chen, Zhuo Yang, Ke Han, Wen Jia
Wen-Wen Zhu, Xu-Lin Chen, Zhuo Yang, Ke Han, Wen Jia, Department of Endoscopy, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
Co-first authors: Wen-Wen Zhu and Xu-Lin Chen.
Author contributions: Zhu WW and Chen XL participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Zhu WW, Chen XL, and Jia W wrote the manuscript; Han K and Yang Z accessed and verified the study data; all authors critically reviewed and provided final approval of the manuscript; and all authors were responsible for the decision to submit the manuscript for publication.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by Shenyang Science and Technology Plan, No. 22-321-32-15; National Natural Science Foundation of China, No. 82500816; Natural Science Foundation of Liaoning Province, No. 2025-BS-0946; and Liaoning Young Elite Scientists Sponsorship Program.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Zhuo Yang, PhD, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110016, Liaoning Province, China. yangzhuocy@163.com
Received: August 4, 2026 Revised: September 6, 2026 Accepted: October 16, 2026 Published online: November 16, 2026 Processing time: 106 Days and 17.8 Hours
Abstract
Hemostatic powder, as an emerging endoscopic hemostatic technique, has demonstrated significant potential in the management of gastrointestinal bleeding (GIB). It offers advantages such as ease of operation and a generally favorable safety profile in the reported studies, particularly in complex anatomy, unclear visual fields, or locations where conventional hemostatic methods are difficult to apply. However, there remains a lack of systematic understanding regarding the specific characteristics and applicable scope of different hemostatic powders. This article reviews existing clinical studies on commonly used hemostatic powders in GIB-related diseases, comprehensively summarizing their current applications, efficacy, and safety profiles. This review highlights the distinct mechanisms and clinical niches for different powders, proposing a stratified management approach for their use. However, its technical characteristics and operator dependency mean that it should be used cautiously in certain high-risk bleeding scenarios, or as part of a combined hemostatic strategy rather than as a first-line monotherapy.
Core Tip: Hemostatic powder is an emerging endoscopic modality for gastrointestinal bleeding that enables rapid, technically simple hemostasis in difficult or anatomically complex bleeding sites. Given the uneven, largely observational evidence base, it is best positioned as a rescue, bridging, or adjunctive option in selected scenarios rather than routine first-line monotherapy. This minireview compares the mechanisms and clinical evidence of available powders and proposes a provisional recommendation.
