Comparison of Hemostatic Effect of Prevailing Endoscopic Therapies on Bleeding Gastric Ulcer
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概要
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In the treatment of hemorrhagic gastric ulcer therapeutic endoscopy is providing a remarkable achievement of successful and safe hemostasis. In this communication we compared the efficacy of 3 major endoscopic treatment modalities and their 2 combinations for bleeding gastric ulcer. A total of 476 consecutive patients presenting with bleeding from gastric ulcer were assigned to undergo endoscopic hemostasis by one of the following 4 therapeutic modalities: hemoclip, ethanol injection, heater grid coagulation, and a combination of hemoclip and ethanol injection or that of hemoclip and heater probe. More than 90% of the 476 patients achieved a permanent hemostasis by either of hemoclip, ethanol injection, heater probe, and one of the two combination therapies regardless of the location of visible vessels, stigmata of bleeding, and general health status at presentation. The combination therapy provided a higher success rate, although statistically not significant. Recurrence of bleeding occurred in 13 (4.4%) of 290 patients presenting with mild shock, 11 (9.3%) of 118 patients with moderate shock, and 14 (20.5%) of 68 patients with severe shock before the therapy, retrospectively, indicating a significantly higher rate of rebleeding in patients presenting with a critical general condition. Endoscopic therapy provide successful and safe hemostasis in bleeding gastric ulcer. Combination of hemoclip and ethanol injection or hemoclip and heater probe coagulation may be the most effective. Severe general heath status at presentation increases the risk of rebleeding.
- 昭和大学・昭和医学会の論文
昭和大学・昭和医学会 | 論文
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