Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding.
OBJECTIVE
To compare the hemostatic efficacy and safety of two mechanical endoscopic methods: endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP) in patients with actively bleeding Mallory-Weiss syndrome (MWS).


METHODS
A prospective randomized study to compare the efficacy and safety of EHP with EBL was performed from January 2002 to August 2005. Forty-one patients with active bleeding from MWS were treated with EHP (n = 21) or EBL (n = 20).


RESULTS
There were no significant differences between groups with respect to clinical and endoscopic characteristics. The mean number of hemoclips applied was 3.2 +/- 1.5 and the mean number of bands applied was 1.2 +/- 0.4. Primary hemostasis was achieved in all patients. Recurrent bleeding was observed in one patient from the EHP group and two from the EBL group. Patients with recurrent bleeding were treated by the same modality as at randomization and secondary hemostasis was achieved in all. There were no significant differences between the two groups in total transfusion amount or duration of hospital stay. No complications or bleeding-related death resulted.


CONCLUSIONS
EHP and EBL are equally effective and safe for the management of active bleeding in patients with Mallory-Weiss syndrome, even in those with shock or comorbid diseases.
Cho
Young-Seok
YS
Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu 480-717, Korea.
Chae
Hiun-Suk
HS
Kim
Hyung-Keun
HK
Kim
Jin-Soo
JS
Kim
Byung-Wook
BW
Kim
Sung-Soo
SS
Han
Sok-Won
SW
Choi
Kyu-Yong
KY
D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005762:Gastroenterology / Q000295:instrumentation / Q000379:methods; D006439:Hemodynamics; D006470:Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000601:surgery* / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome