PROSPECTIVE COMPARISON OF ARGON PLASMA COAGULATOR AND HEATER PROBE INTHE ENDOSCOPIC TREATMENT OF MAJOR PEPTIC-ULCER BLEEDING

Background: Argon plasma coagulator was prospectively compared with he ater probe in patients with bleeding peptic ulcers. Methods: Forty-one patients with major stigmata of ulcer hemorrhage were randomly assign ed to receive either heater probe (n = 20) or argon plasm coagulation (n = 21) treatment; 40% had active bleeding and 60% had a nonbleeding visible vessel in the ulcer crater. The two groups were similar with r espect to all background variables. Episodes of recurrent bleeding wer e retreated with the same modality as used; previously, Patients in wh om treatment or retreatment failed underwent emergency surgery. Result s: Initial hemostasis (95% vs. 95.2%), recurrent bleeding (21% vs. 15% ), 30-day mortality (5% vs. 4.7%), and emergency surgery (15% vs. 9.5% ) were comparable in the heater probe and argon plasma coagulation gro ups, respectively. Argon plasma coagulation provided faster hemostasis (mean 60 +/- 10 vs. 115 +/- 28 seconds, p < 0.05). Conclusions: Argon plasma coagulation is safe and effective. Larger studies in patients with bleeding peptic ulcers are needed to confirm these promising resu lts.