ENDOSCOPIC HEMOSTASIS BY LOCAL APPLICATION OF GELATIN SOLUTION

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概要

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• This report presents a new method of endoscopic hemostasis with gelatin solution (GS); 1g gelatin powder (Gelfoam) in 30ml of 20% glucose. GS injected into the submucosal layer compresses bleeding vessels of the submucosal layer. In an experimental canine model, safety of this method was comfirmed by histological examination a week after injection of GS revealing no mucosal injury or inflammatory change of the submucosal layer. This hemostatic method was attempted in 24 patients with UGI bleeding (gastric ulcer, 16; duodenal ulcer, 3; telangiectasia, 5;) and 21 patients with LGI bleeding (polypectomy stump, 6; telangiectasia, 2; bleeding polyp, 2; dilated vein, 3; hematocyst, 2; diverticulum, 1; ulcer, 4; malignant lymphoma, 1). Twenty four patients with UGI bleeding and 10 patients with LGI bleeding required blood trasf usion because of marked bleeding when hemostasis was attempted. Complete hemostasis was achieved in 24 patients (100%) with UGI bleeding and in 20 patients (95%) with LGI bleeding. Rebleeding occured in 1 patient with malignant lymphoma of the rectum within a month of hemostasis. Four patients with LGI bleeding, 1 patient with malignant lymphoma and 3 patients with ulcerative colitis were electively operated on following hemostasis. No serious complica-tions were encountered during and after hemostasis. No ulcer was induced at the site where GS was injected. Endoscopic ultrasonography was performed in 3 patients and revealed complete disappearence of GS within two months of hemostasis in all patients without sequela. It is, therefore concluded that endoscopic hemostasis with GS is an ideal, easy method for GI bleeding compared with other endoscopic techniques.

• 社団法人 日本消化器内視鏡学会の論文

社団法人 日本消化器内視鏡学会 | 論文

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