A team from Naples, Italy, compared the endoscopic application of hemoclips (HC) with heat probe (HP) treatment in patients with bleeding ulcers.
In the study, 113 patients with major stigmata of ulcer hemorrhage were randomly assigned to receive HP (n = 57) or HC (n = 56). Clinical and endoscopic features were comparable in both groups.
Recurrent bleeding was retreated with the modality previously used. Patients in whom treatment or re-treatment was unsuccessful underwent emergency surgery.
Hemostasis, adequate treatment of visible vessel, 30-day mortality, and emergency surgery rates were found to be similar for both groups.
Incidence of recurrent bleeding was 21% for HP and 1.8% for HC.
Length of hospital stay, and transfusion requirements, were significantly lower in the HC group.
Incidence of recurrent bleeding after treatment:|
Heater probe: 21%
The team found no evidence of clip-induced tissue injury or impaired ulcer healing. Clips dislodged spontaneously in most patients within 8 weeks of treatment, and no further hemorrhage occurred on a median follow-up of 11 months.
Dr Livio Cipolletta concluded on behalf of the group, "The hemoclip is safe and effective in the treatment of severe ulcer bleeding and is superior to HP in preventing early recurrent bleeding."