Korean J Gastrointest Endosc.  2006 Jan;32(1):9-14.

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

• Seo HE
• Lee MK
• Lee YD
• Jeon SW
• Cho CM
• Tak WY
• Kwon YO
• Kim SK
• Choi YH
• Eun JR

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.

Keyword

Peptic ulcer bleeding; Epinephrine injection; Hemoclip

MeSH Terms

Emergencies
Endoscopy
Epinephrine*
Hemorrhage*
Hemostasis
Hemostasis, Endoscopic
Humans
Peptic Ulcer*
Retrospective Studies
Epinephrine