Nonvariceal upper gastrointestinal bleeding. New and alternative hemostatic techniques.
In upper gastrointestinal bleeding, endoscopic management does reduce rates of rebleeding, surgery, and mortality. In active bleeding, however, early recurrence still occurs in around 20% despite successful initial hemostasis. Several new techniques or modifications of endoscopic hemostatic methods have been invented to improve the results. They include ligating devices, biological injection agents, argon plasma coagulation, and hemoclips. Hemoclips and injection therapy using fibrin glue do not cause relevant tissue damage and appear to have better results in terms of lower rebleeding rates. Fibrin glue seems to be effective only if injected repeatedly. Due to limited experience, no final conclusion can be made at this stage. Further clinical investigation is warranted.
Soehendra
N
N
Department of Endoscopic Surgery, University Hospital Eppendorf, 20246 Hamburg, Germany.
Bohnacker
S
S
Binmoeller
K F
KF
D002986:Clinical Trials as Topic; D004564:Electrocoagulation / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011379:Prognosis; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome
D012597:Sclerosing Solutions