Document Detail


Evaluation of endoscopic hemostasis with metallic hemoclips for bleeding gastric ulcer: comparison with endoscopic injection of absolute ethanol in a prospective, randomized study.
MedLine Citation:
PMID:  14572568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although metallic hemoclips have been used for hemostasis of bleeding ulcer, there have been few prospective trials to evaluate their efficacy. In this study, a prospective, randomized trial was performed to evaluate endoscopic hemoclipping for bleeding gastric ulcer in comparison with endoscopic injection of absolute ethanol. METHODS: During the period 1995-1998, 126 gastric ulcer patients with bleeding or nonbleeding visible vessel were considered for entry. They were randomly assigned to one of three groups: endoscopic hemostasis performed with injection of absolute ethanol (group I, n = 42), hemoclipping (group II, n = 42), and a combination of the two methods (group III, n = 42). RESULTS: The permanent hemostatic rate was 85.7% in group I, 90.5% in group II, and 92.9% in group III. The mean volume of blood transfusion was 313 +/- 77 ml in group I, 274 +/- 54 ml in group II, and 163 +/- 42 ml in group III, which was significantly less than in groups I or II (p < 0.05). No patients required emergency surgery. Five patients died within a month after initial hemostasis as a result of unrelated conditions. CONCLUSIONS: Endoscopic hemostasis with hemoclips for bleeding gastric ulcer was as effective and safe as that with injection of absolute ethanol, and a combination of ethanol injection and hemoclips did not result in a great advantage over the two individual procedures.
Authors:
Ryo Shimoda; Ryuichi Iwakiri; Hiroyuki Sakata; Shinichi Ogata; Atsushi Kikkawa; Hibiki Ootani; Kayoko Oda; Akifumi Ootani; Seiji Tsunada; Kazuma Fujimoto
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  98     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-23     Completed Date:  2003-11-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2198-202     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan.
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MeSH Terms
Descriptor/Qualifier:
Equipment Design
Ethanol / administration & dosage*
Female
Follow-Up Studies
Hemostasis, Endoscopic / instrumentation*,  methods
Humans
Injections, Intralesional
Male
Metals
Middle Aged
Peptic Ulcer Hemorrhage / diagnosis,  therapy*
Prospective Studies
Reference Values
Sclerosing Solutions / therapeutic use
Sensitivity and Specificity
Severity of Illness Index
Stomach Ulcer / diagnosis,  therapy*
Surgical Instruments
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals; 0/Sclerosing Solutions; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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