THE EFFECT OF ENDOSCOPIC INJECTION THERAPY ON THE CLINICAL OUTCOME OFPATIENTS WITH BENIGN PEPTIC-ULCER BLEEDING

Background: Our aim was to investigate the effect of endoscopic inject ion therapy on the clinical outcome of patients with benign peptic ulc er bleeding. Methods: In this study 1203 patients admitted with peptic ulcer bleeding over a 5-year period (January 1987 to April 1991) befo re endoscopic therapy and 1028 patients admitted with peptic ulcer ble eding after introduction of endoscopic therapy (May 1991 to March 1996 ) were assessed. Endoscopic therapy was performed in all patients with active bleeding or nonbleeding visible vessels during emergency endos copy with injection of adrenaline, 1:10,000 in 0.9% saline. Results: T he introduction of injection therapy was associated with a reduction i n transfusion requirements (from 5.1 +/- 2.6 to 3.4 +/- 1.8 units), ho spitalization days (from 10.8 +/- 6.5 to 7.8 +/- 5.1 days), surgical i nterventions (from 50.6% to 23.6%), and mortality (from 12.9% to 4.6%) in patients with active bleeding or non-bleeding visible vessels (P < 0.05) but remained unchanged in the rest. Patients with gastric ulcer had a more pronounced reduction in emergency surgical haemostasis and mortality than patients with duodenal ulcer. There were no deaths or procedure-related complications. Conclusion: Endoscopic injection ther apy with adrenaline/saline is a simple, low-cost, and safe method that improves the clinical outcome and reduces the mortality in patients w ith peptic ulcer bleeding.