ENDOSCOPIC HEMOSTASIS OF BLEEDING PEPTIC-ULCERS

Developments in therapeutic endoscopy over the last decade have made i t possible to perform endoscopic hemostasis for bleeding peptic ulcers . This review traces the developments in this field in the Department of Surgery of the National University of Singapore. A recently conduct ed prospective randomized controlled trial using intralesional adrenal ine and heater probe demonstrated that initial hemostasis could be ach ieved in 100% of patients with actively bleeding ulcers or stigmata of recent hemorrhage. The rebleed rate was 6.6% compared with 20.3% in a well-matched control group. The recent advent of laparoscopic vagotom y and laparoscopic Billroth II gastrectomy offers a low-morbidity surg ical option to long-term medical treatment for the follow-up managemen t of patients with bleeding ulcers.