Endoscopic hemostasis for bleeding peptic ulcer using a hemostatic clip or pure ethanol injection.
OBJECTIVE
Endoscopic hemostasis is frequently chosen as the treatment of first choice for bleeding peptic ulcers. We retrospectively compared the hemostatic effects of hemoclips and endoscopic ethanol injection in patients with bleeding gastric and duodenal ulcers.


METHODS
The subjects were 149 patients with 156 bleeding peptic ulcer lesions who were treated by endoscopic hemostasis, comprising 127 gastric ulcers and 29 duodenal ulcers. Hemoclips were used for 68 lesions (hemoclip group) and ethanol injection was done for 88 lesions (ethanol group).


RESULTS
The hemostasis rates were 98.5% for the hemoclip group and 92.0% for the ethanol group. There was no significant difference in hemostatic effect between these two methods. All patients with unsuccessful hemostasis had a visible vessel larger than 2.0 mm in diameter and/or concomitant disease.


CONCLUSIONS
The results suggest that these two endoscopic hemostatic methods are both highly effective. The presence of a large visible vessel may be predictive of unsuccessful hemostasis.
Nishiaki
M
M
First Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan.
Tada
M
M
Yanai
H
H
Tokiyama
H
H
Nakamura
H
H
Okita
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D000431:Ethanol