title: A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers.
abstract: BACKGROUND
  Although endoscopic hemoclip therapy is widely used in the treatment of GI bleeding, there are few prospective trials that assess its efficacy. This study evaluated the efficacy and safety of hemoclip placement and distilled water injection for the treatment of high-risk bleeding ulcers.
  
  
  METHODS
  Seventy-nine patients with major stigmata of ulcer hemorrhage were randomly assigned to either endoscopic hemoclip placement (n = 39) or injection with distilled water (n = 40).
  
  
  RESULTS
  Initial hemostasis was achieved in all patients treated with hemoclips and 39 treated by distilled water injection (respectively, 100.0% vs. 97.5%; p = 1.00). Bleeding recurred in 4 and 11 of patients, respectively, in the hemoclip and water injection groups. It occurred significantly more frequently in the injection group (hemoclip, 10.3%; injection, 28.2%; p = 0.04). No major procedure-related complication occurred in either group. Emergency operations were performed in 5.1% of patients treated with hemoclips versus 12.5% of those in the water injection group (p = 0.43). Hospital days and mortality rate were similar in both groups.
  
  
  CONCLUSIONS
  Endoscopic hemoclip placement is a safe and effective hemostatic method that is superior to distilled water injection for treatment of bleeding peptic ulcer.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Surgery, Kaohsiung Veterans General Hospital, Kaohsiung Military General Hospital, National Yang-Ming University, Kaohsiung 813, Taiwan.
authors.forename: Yuh-Chyi
authors.initials: YC
authors.lastname: Chou
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Lai
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Lo
authors.forename: Hoi-Hung
authors.initials: HH
authors.lastname: Chan
authors.forename: Chi-Pin
authors.initials: CP
authors.lastname: Lin
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
authors.forename: Chang-Bih
authors.initials: CB
authors.lastname: Shie
authors.forename: E-Ming
authors.initials: EM
authors.lastname: Wang
authors.forename: Nan-Hua
authors.initials: NH
authors.lastname: Chou
authors.forename: Wency
authors.initials: W
authors.lastname: Chen
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
mesh_terms: D005260:Female; D016558:Hemostasis, Endoscopic / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D014867:Water / Q000008:administration & dosage*
chemical_list: D014867:Water