A team from Brescia, Italy compared two hemostatic procedures in the treatment of peptic ulcer bleeding.
223 patients were selected from 1,003 emergency upper endoscopies for GI bleeding.
According to Forrest's criteria, 99 well-matched patients with ulcers F1 and F2 were considered at risk of rebleeding. Of these, 54 patients (group A) received local ulcer injection of epinephrine solution 1:10,000, whereas (group B) patients were treated with local epinephrine injection and then with endoscopic Hemoclips.
|223 patients were selected from 1,003 emergency upper endoscopies for GI bleeding.|
|Am J Gastroenterol |
The team assessed the control of bleeding, the number of rebleeding episodes, the need for emergency surgery, and mortality.
The researchers found that bleeding ulcers stopped completely in 83% of group A patients, and in 96% of group B patients.
In a subset of F1b patients the rebleeding rate was 31% for group A and 0% for group B.
There was a trend toward reducing surgery in favor of the combined therapy (0% vs. 7%). No differences were found in transfusion requirements or mean hospitalization days. There was no mortality as a result of the procedure.
Researcher F. Buffoli said on behalf of the group, "Endoscopic injection of 1:10,000 epinephrine solution alone and epinephrine plus application of Hemoclips are equivalent therapies in treating bleeding and rebleeding from peptic ulcers. There was no difference between therapies in terms of need for surgery or mortality."
"Combination therapy may be more effective in treating ulcers that are actively oozing," it was concluded.