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

Korean J Gastrointest Endosc > Volume 32(1); 2006 > Article

Korean Journal of Gastrointestinal Endoscopy 2006;32(1): 9-14.

소화성 궤양 출혈에서 에피네프린 국소 주사 단독 치료와 지혈 클립과의 병용 치료의 지혈 효과 비교

서향은·이명권·이영두·전성우·조창민·탁원영·권영오·김성국·최용환·은종렬*

경북대학교 의과대학 내과학교실, *영남대학교 의과대학 내과학교실

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

Hyang Eun Seo, M.D., Myung Kwon Lee, M.D., Young Doo Lee, M.D., Seong Woo Jeon, M.D., Chang Min Cho, M.D., Won Young Tak, M.D., Young Oh Kwon, M.D., Sung Kook Kim, M.D., Yong Hwan Choi, M.D. and Jong Ryul Eun, M.D.*

Department of Internal Medicine, Kyungpook National University College of Medicine, *Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea

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. (Korean J Gastrointest Endosc 2006;32:9⁣14)

Key Words: Peptic ulcer bleeding, Epinephrine injection, Hemoclip

주요어: 소화성 궤양 출혈, 에피네프린 국소 주사, 지혈 클립