Endoscopy pp 8-14 | Cite as

Endoscopic Injection Therapy of Gastroduodenal Ulcer Hemorrhage: A Randomized Comparison of Fibrin Sealant vs. Polidocanol

  • R. Salm
  • K. E. Grund
  • J. Sontheimer
  • A. Bustos
  • E. Weber
Conference paper
Part of the Fibrin Sealing in Surgical and Nonsurgical Fields book series (ADMERE, volume 8)

Abstract

In a randomized trial involving 56 patients with acute gastroduodenal ulcer hemorrhage we examined the rebleeding rate after endoscopic local injection of fibrin sealant (group A, n = 30) in comparison to polidocanol (group B, n = 26). Included were ulcers with spurting (Forrest Ia) or oozing bleeding (F lb) or a visible vessel (F IIa). In case of F Ia/Ib the endoscopic therapy in both groups was combined with a preliminary injection of epinephrine (1:104). After endoscopic hemostasis the patients were transferred to the surgical intensive care unit. The patients underwent routine endoscopy 24 h later. If rebleeding signs occurred, emergency endoscopy was performed. In the case of rebleeding or a still visible vessel another injection therapy now with fibrin sealant in both groups was performed. Initial hemostasis was achieved in 100% of cases in group A and in 77% in group B (p ≤ 0.05). Recurrent hemorrhage occurred in 10% in group A and in 38% in group B (p ≤ 0.05). Permanent hemostasis was achieved in 93% in group A and 88% in group B. There were no differences between the two groups in the requirement for emergency surgery or mortality. A tendency toward a lower blood transfusion requirement was observed in group A, but it failed to achieve statistical significance. No complications of injection therapy were noted.

Keywords

Steam Sodium Chloride Epinephrine Perforation Thrombin 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • R. Salm
  • K. E. Grund
  • J. Sontheimer
  • A. Bustos
  • E. Weber

There are no affiliations available

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