[Evaluation of using fibrin tissue adhesive (Beriplast) and preparations of thrombin and adrenalin in injection hemostasis methods for gastric and duodenal ulcer hemorrhage. Randomized, prospective clinical trial].
A prospective randomized trial involving 30 patients was performed to assess whether second-look endoscopy could improve the efficacy of injection therapy for bleeding peptic ulcers. The inclusion criteria were the presence of active arterial bleeding or a non-bleeding visible vessel at emergency endoscopy. All the patients received emergency injection of thrombin with adrenaline solution and were subsequently randomized (15 patients in each group). All the patients receive a second elective endoscopy within the first 24 hours with repeated injection of thrombin-adrenaline solution (Group I) or fibrin sealant-Beriplast-(Group II). A tendency towards better results was noted in the Group II. Recurrent bleeding was observed in 6.6% versus 26.6% patients in Group I. The need for emergency surgery occurred in (6.6% in Group I versus 0 in Group II) and length of hospital stay was (13.2 in Group I versus 7.4 in Group II [p < 0.05]). No mortality was observed in both of the groups. In conclusion, our data suggest the possibility of a small benefit with second-look endoscopy with repeated injection of fibrin sealant.
Babicki
A
A
II Katedry i Kliniki Chirurgii Ogólnej, Gastroenterologicznej i Endokrynologicznej Akademii Medycznej w Gdańsku.
Dobosz
M
M
Marczewski
R
R
Wajda
Z
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000628:therapy; D004630:Emergencies; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D013276:Stomach Ulcer / Q000628:therapy; D015996:Survival Rate; D013917:Thrombin / Q000008:administration & dosage*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014662:Vasoconstrictor Agents; D013917:Thrombin; D004837:Epinephrine