Vojnosanitetski pregled 2013 Volume 70, Issue 9, Pages: 824-829
https://doi.org/10.2298/VSP110411009G
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Could application of epinephrine improve hemostatic efficacy of hemoclips for bleeding peptic ulcers? A prospective randomized study
Grgov Saša (Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac)
Radovanović-Dinić Biljana (Clinic for Gastroenterology and Hepatology, Clinical Center Niš, Niš)
Tasić Tomislav (Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac)
Background/Aim. Bleeding from peptic ulcers can be effectively and safely
treated with endoscopic hemoclips therapy. However, due to certain limiting
factors of hemoclips, application of combination with another endoscopic
method may give better results. The aim of this study was to examine the
efficacy and safety of endoscopic hemoclips therapy and to evaluate potential
benefits of this therapy combined with epinephrine in the treatment of
bleeding peptic ulcers. Methods. This prospective randomized study included
70 patients with bleeding gastric or duodenal ulcer. In 34 of the patients
endoscopic hemoclips therapy was applied (group I), and in 36 of them a
combined therapy of hemoclips and epinephrine (group II). Results. Initial
hemostasis was achieved in most patients treated with endoscopic hemoclips
therapy (94.1%) as well as in the patients treated with combination therapy
(97.2%). After initial hemostasis achieved rebleeding occurred in 3 (9.3%)
patients treated with hemoclips and in 2 (5.7%) patients treated with
combination therapy, but this difference was not statistically significant (p
> 0.05). The difference in the achieved final hemostasis between the group I
(91.1%) and the group II (94.4%) was not statistically significant. Also, the
differences between the two groups of patients in the need for blood
transfusions, length of hospital stay, need for surgery and mortality were
not statistically significant (p > 0.05). Conclusion. Endoscopic hemoclips
therapy is effective and safe in treatment of bleeding peptic ulcers.
Combination therapy of hemoclips and epinephrine has no advantage over
hemoclips monotherapy.
Keywords: peptic ulcer hemorrhage, endoscopy, gastrointestinal, hemostasis, endoscopic, epinephrine, treatment outcome