Document Detail


Factors associated with failure of initial endoscopic hemoclip hemostasis for upper gastrointestinal bleeding.
MedLine Citation:
PMID:  16340629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endoscopic hemoclip is widely used for the management of bleeding peptic ulcers. The major difficulty in clinical application of the hemoclip is deployment to the lesion during initial hemostasis. The aim of this study was to define factors associated with the failure of endoscopic hemoclip for initial hemostasis of upper GI bleeding. PATIENTS AND METHODS: From January to December 2003, we prospectively studied 77 randomized patients with clinical evidence of upper GI bleeding due to either active bleeding or a visible vessel identified by upper GI endoscopy in our emergency department. RESULTS: Among the 77 patients, 13 (16.9%) failed treatment (Group 1) and 64 (83.1%) were successfully (Group 2) treated by endoscopic hemoclip for lesions related to upper GI bleeding. There were no differences due to gender, blood pressure, initial heart rate, and hemoglobulin before or after endoscopic treatment, platelet count, serum creatinine, and albumin between groups. The mean age of Group 1 was higher than that of Group 2 (73.31+/-9.38 years vs. 65.41+/-16.45 years, respectively; P=0.083). Most patients who did not achieve initial hemostasis by endoscopic hemoclip had upper GI lesions over the gastric antrum and duodenal bulb. Among the 13 patients who failed to achieve endoscopic hemoclip initial hemostasis, four lesions were located over the posterior wall of the antrum, and four lesions over the lesser curvature side of the duodenal bulb. CONCLUSION: Endoscopic hemoclip is an effective hemostatic method for upper GI bleeding. Age, gastric antrum, and duodenal bulb lesions may be associated with the failure of initial hemostasis by endoscopic hemoclip.
Authors:
Yen-Chun Peng; Show-Yun Chen; Chun-Fang Tung; Wai-Keung Chou; Wei-Hsiung Hu; Dar-Yu Yang
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  40     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-03-16     Revised Date:  2006-11-14    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  25-8     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, and National Yang-Ming University, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Female
Gastrointestinal Hemorrhage / prevention & control*
Hemostasis, Endoscopic / instrumentation*
Humans
Male
Prospective Studies
Risk Factors
Statistics, Nonparametric
Treatment Failure
Treatment Outcome
Comments/Corrections
Comment In:
J Clin Gastroenterol. 2006 Jul;40(6):562-3; author reply 563   [PMID:  16825946 ]

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


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