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Background The hemostatic efficacy of mechanical methods of hemostasis, togeth er with epinephrine injection, was compared with that of epinephrine injection a lone in bleeding peptic ulcer.Methods Ninety patients with a peptic ulcer with a ctive bleeding or a non-bleeding visible vessel were randomly assigned to under go a mechanical method of hemostasis (23 hemoclipapplication, 22 band ligation) plus epinephrine injection, or epinephrine injection alone. Results The two grou ps were similar with respect to all background variables. Initial hemostasis was achieved in 44/45 (97.8%) patients in both groups. The mean number of hemoclip s and elastic bands applied were 2.8: 95%CI<<2.5, 3.1>> and 1.1: 95%CI<<1.0, 1.2>> , respectively,and the mean volume of epinephrine injected was 19.9 mL:95%CI<<19 .3 mL, 20.5 mL>>. The rate of recurrent bleeding in the combination group (2/44, 4.5%) was significantly lower in comparison with the injection group (9/44, 20. 5%, p < 0.05).The mean number of therapeutic endoscopic sessions needed to achi eve permanent hemostasis in the combination group (1.04:95%CI<<1.01, 1.07>>) was significantly lower vs. the injection group (1.22: 95%CI<<1.15, 1.30>>). Conclusi ons The combination of an endoscopic mechanical method of hemostasis plus epinep hrine injection is more effective than epinephrine injection alone for the treat ment of bleeding peptic ulcer.
Background The hemostatic efficacy of mechanical methods of hemostasis, togeth er with epinephrine injection, was compared with that of epinephrine injection a lone in bleeding peptic ulcer. Methods Ninety patients with a peptic ulcer with a ctive bleeding or a non-bleeding visible vessel were randomly selected Assigned to under go a mechanical method of hemostasis (23 hemoclipapplication, 22 band ligation) plus epinephrine injection, or epinephrine injection alone. Results The two grou ps were similar to respect to all background variables. Initial hemostasis was achieved in 44/45 (97.8 %) patients in both groups. The mean number of hemoclip and elastic bands applied were 2.8: 95% CI << 2.5, 3.1 >> and 1.1: 95% CI << 1.0, 1.2 >>, respectively, and the mean volume of epinephrine was 19.9 mL: 95% CI << 19 .3 mL, 20.5 mL >>. The rate of recurrent bleeding in the combination group (2/44, 4.5%) was significantly lower in comparison with the injection group (9 / 44, 20.5%, p <0.05) therapeutic endoscopic sessions needed to achi eve permanent hemostasis in the combination group (1.04: 95% CI << 1.01, 1.07 >>) was significantly lower vs. the injection group (1.22: 95% CI << 1.15, 1.30 >>). Conclusi ons The combination of an endoscopic mechanical method of hemostasis plus epinep hrine injection is more effective than epinephrine injection alone for the treat ment of bleeding peptic ulcer.