Efficacy of endoscopic techniques for management of peptic ulcer bleeding

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Created On: 24/02/2022

The study aimed to compare the effectiveness of high and low-dose epinephrine & endoclip application to prevent acute peptic ulcer bleeding.

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Key take away

Endoclip therapy can be the primary intervention for patients suffering from peptic ulcer bleeding. When necessary, the addition of epinephrine can be taken into consideration.

Background

The study aimed to compare the effectiveness of high and low-dose epinephrine & endoclip application to prevent acute peptic ulcer bleeding.

Method

A total of 180 patients with peptic ulcer bleeding were hospitalized and segregated into three groups, (I) Endoclip and low-dose epinephrine injection 0–2 mg (Group A, 62 patients), (II) Endoclip and high-dose epinephrine injection 2–4 mg (Group B, 54 patients), and (III) Endoclip only (Group C, 64 patients). Bleeding and complication rates were evaluated.

Result

The permanent hemostasis and early bleeding reported in Group B were higher. There was no substantial difference between the groups when evaluated in terms of late hemostasis and urgent surgical requirement. Group B was given a higher quantity of blood and exhibited a longer hospital stay when compared to Groups A and C.

But, if the patient is suffering from hypovolemic shock, the Rockall score is elevated and the size of the ulcer is larger than 2 cm, endoclip application can be utilized as the main therapy and epinephrine injection can be taken into consideration when imperative.

Thirty-day mortality and endoscopic success rates reported in study groups are listed in table 1:

Conclusion

All the procedures were useful to prevent acute peptic ulcer bleeding. Endoclip therapy can be the main first-line therapeutic option for uncomplicated peptic ulcer bleeding.