Surgical endoscopy
-
Clinical Trial Controlled Clinical Trial
Reduction of surgery and mortality rate of bleeding peptic ulcer by endoscopic haemostasis with alcohol.
Eighty patients with peptic ulcers (45 duodenal ulcers, 30 gastric ulcers, and 5 stomal ulcers) presented at our emergency endoscopy unit with acute upper gastrointestinal haemorrhage (Forrest Ia, spurting bleeding; Forrest Ib, oozing bleeding) or stigmata of recent bleeding (Forrest II). They were divided into two groups, A and B, according to the day of the week on which emergency endoscopy was performed. Group A, consisting of 39 patients (24 duodenal ulcers, 13 gastric ulcers, and 2 stomal ulcers) was submitted to conventional treatment (blood transfusions, antacids, cimetidine, pirenzepine). ⋯ Endoscopic injection of absolute alcohol succeeded in arresting the haemorrhage in 17 of the 18 Forrest Ia and Ib cases and prevented recurrence in all Forrest II cases. Significant differences were recorded between the two groups as regards the number of patients undergoing surgery (18 to 7), emergency surgery (14 to 1) and the mortality (15% compared to 2.4%). The greatest difference was recorded between the postoperative mortality (27% in group A and 0% in group B).(ABSTRACT TRUNCATED AT 250 WORDS)