Hj. Lin et al., Comparison of adrenaline injection and bipolar electrocoagulation for the arrest of peptic ulcer bleeding, GUT, 44(5), 1999, pp. 715-719
Background-Peptic ulcers with active bleeding or a non-bleeding visible ves
sel require aggressive endoscopic treatment.
Aims-To determine whether endoscopic adrenaline injection alone or contact
probe therapy following injection is a suitable treatment for peptic ulcer
bleeding.
Methods-A total of 96 patients with active bleeding or non-bleeding visible
vessels received adrenaline alone, bipolar electrocoagulation alone, or co
mbined treatment (n=32 in each group).
Results-Initial haemostasis was not achieved in one patient in the adrenali
ne group, two in the gold probe group, and two in the injection gold probe
group (p>0.1). Rebleeding episodes were fewer in the injection gold probe g
roup (2/30, 6.7%) than in the gold probe group (9/30, 30%, p=0.04) and in t
he adrenaline group (11/31, 35.5%, p=0.01). Treatment failure (other therap
y required) was rarer in the injection gold probe group (4/32, 12.5%) than
in the adrenaline group (12/32, 37.5%, p=0.04). The volume of blood transfu
sed after entry of the study was less in the injection gold probe group (me
an 491 ml) than in the adrenaline group (1548 mi, p<0.0001) and the gold pr
obe group (1105 ml, p<0.01). Duration of hospital stay, numbers of patients
requiring urgent surgery, and death rate were not statistically different
among the three groups.
Conclusions-For patients with peptic ulcer bleeding, combined adrenaline in
jection and gold probe treatment offers an advantage in preventing rebleedi
ng and decreasing the need for blood transfusion.