Comparison of Hemostatic Efficacy between Epinephrine Injection Alone and a Combined Therapy with Hemoclip for Bleeding Peptic Ulcers / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: Many studies have been performed to find the differences between using epinephrine injection alone and a combination therapy with hemoclip for bleeding peptic ulcer, but the results have been controversial. We retrospectively evaluated the hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip for bleeding peptic ulcers. METHODS: Four hundred patients were enrolled. They were assigned to one of the two groups endoscopic hemostasis with injection of epinephrine (group I, n=156) and combined epinephrine injection with hemoclip (group II, n=244). RESULTS: The continuous bleeding rate was significantly higher in group I than in group II. The recurrent bleeding rate was also significantly higher in group I than in group II. There were no statistical differences in the rates of death, emergency surgery and arterial embolization. The rates of continuous bleeding and the initial failure of hemostasis were higher for the patients with active bleeding on the initial endoscopy irrespective of the applied hemostatic methods. CONCLUSIONS: A combination of epinephrine injection and hemoclip is more effective than epinephrine injection alone for treating bleeding peptic ulcers.