Controlled Comparison of Endoscopic Epinephrine Injection and Endoscopic Argon Plasma Coagulation for the Treatment of Acute Peptic Ulcer Bleeding

Korean J Gastrointest Endosc > Volume 32(4); 2006 > Article

Korean Journal of Gastrointestinal Endoscopy 2006;32(4): 239-245.

급성 소화성 궤양 출혈에서 내시경적 에피네프린 국소 주입법과 내시경적 아르곤 플라즈마 응고 소작법의 비교

배경임·이상혁·김희·이상봉·이재호·박성재·지삼룡·박은택·이연재·설상영·정정명

인제대학교 의과대학 부산백병원 내과학교실

Controlled Comparison of Endoscopic Epinephrine Injection and Endoscopic Argon Plasma Coagulation for the Treatment of Acute Peptic Ulcer Bleeding

Kyung Im Pae, M.D., Sang Hyuk Lee, M.D., Hee Kim, M.D., Sang Bong Lee, M.D., Jae Ho Lee, M.D., Sung Jae Park, M.D., Sam Ryong Jee, M.D., Eun Taek Park, M.D., Yeon Jae Lee, M.D., Sang Young Seol, M.D. and Jung Myung Chung, M.D.

Department of Internal Medicine, Inje University College of Medicine, Paik Hospital, Busan, Korea

Abstract

Background/Aims:
Endoscopic injection therapy with hypertonic saline Epinephrine (HSE) is the easiest and most widely used procedure for the management of peptic ulcer bleeding. Argon plasma coagulation (APC) is a recently introduced endoscopic hemostatic procedure. Thus, we performed a prospective trial to compare the hemostatic efficacy of APC and HSE.
Methods:
Forty patients with the diagnosis of bleeding ulcer were randomly assigned to receive either HSE (n=20) or APC (n=20) treatment during the period of September 2003 to April 2004. The two groups were matched for gender, age, site of bleeding, the endoscopic findings and the initial hemoglobin at the study baseline.
Results:
The bleeding was initially controlled in 18 patients (90%) of the APC group, and in 20 patients (100%) of the HSE group. Rebeeding occurred in one patient (5%) of the APC group and in 3 patients (15.5%) of the HSE group. The lengths of stay in the hospital were 11.7 days in the APC group and 10.7 days in the HSE group. Death occurred in 1 case in the APC group and in 1 case in the HSE group. The initial hemostatic efficacy showed no difference between the two groups.
Conclusions:
Argon plasma coagulation is as effective as hypertonic saline epinephrine injection for the initial management of acute peptic ulcer bleeding. (Korean J Gastrointest Endosc 2006;32:239⁣245)

Key Words: Argon plasma coagulation, Hypertonic saline epinephrine, Peptic ulcer bleeding

주요어: 아르곤 플라즈마 응고 소작법, 에피네프린 국소 주입법, 상부 위장관 출혈