Prevention of recurrent bleeding from gastric ulcer with a nonbleeding visible vessel by endoscopic injection of absolute ethanol: A prospective, controlled trial

Kõyama, T.; Fujimoto, Kazuma; Iwakiri, Ryuichi; Sakata, Hiroyuki; Sakata, Yasushi; Yamaoka, Kotaro; Yamaguchi, M.; Sakai, Takahiro; Hisatsugu, Takeharu

doi:10.1016/s0016-5107(95)70068-4

Cited by 31 publications

(13 citation statements)

References 27 publications

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“…The eradication of H. pylori is known to reduce the recurrence of peptic ulcers [4,5] and rehemorrhage [6]. However, upper gastrointestinal bleeding is still one of the most common and serious clinical complications of peptic ulcers [7][8][9][10][11][12][13]. In the past 25 years, various endoscopic hemostatic methods for bleeding ulcers have been developed, and endoscopic hemostasis is the first-choice treatment for upper gastrointestinal bleeding.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial

Arima

Sakata

Ogata³

et al. 2009

J Gastroenterol

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Section: Introductionmentioning

confidence: 99%

Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial

Arima

Sakata

Ogata³

et al. 2009

J Gastroenterol

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“…The outpatients were further classified into 2 subgroups: those who visited the hospital emergency unit during regular hours (08: 30 to 17: 00 on weekdays; n = 120) and those who visited the hospital emergency unit during off hours (17: 00 to 8: 30 on weekdays or on weekends/holidays; n = 187). Hemostasis was achieved in all patients in the present study with endoscopic maneuvers including hemoclip application, pure ethanol injection and/or electrocoagulation, as previously described [1, 2, 11-13]. After endoscopic hemostasis, all patients were hospitalized and managed with conventional therapies, including nil oral intake, intravenous fluids and acid secretion inhibitors.…”

Section: Methodsmentioning

confidence: 99%

Outcomes of Patients Undergoing Endoscopic Hemostasis for the Upper Gastrointestinal Bleeding Were Not Influenced by the Timing of Hospital Emergency Visits: A Situation Prevailing in Japan

Matsuura¹,

Sakata²,

Tsuruoka³

et al. 2018

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Background: The aim of the present study was to determine differences in the prognosis of patients in Japan who underwent emergency endoscopic hemostasis (i) during regular hours versus off hours and (ii) as outpatients versus hospitalized patients. Methods: The present retrospective study included 443 patients who underwent emergency endoscopic hemostasis for non-variceal upper gastrointestinal bleeding from January 2008 to December 2014. These patients were classified into 2 groups: hospitalized patients and outpatients. The outpatients were further subclassified into those who visited the hospital during regular hours and those who visited during off hours. Results: The outcomes of outpatients who underwent emergency hemostasis during off hours did not differ from patients treated during regular hours. Multivariate analysis revealed that outcomes of hospitalized patients, including mortality, need for blood transfusion and length of hospitalization, were worse than those of outpatients; it also revealed that patient age, malnutrition rate and prevalence of diabetes and neoplasms were higher among hospitalized patients than those in outpatients. Conclusions: The clinical outcomes of patients who underwent emergency endoscopic hemostasis for upper gastrointestinal bleeding during off hours did not differ from those of patients treated during regular hours. Outcomes were worse among hospitalized patients, mainly because of their bad general condition.

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“…During the study period, several endoscopic hemostatic methods had been used to manage UGIB, including high-frequency soft coagulation [22], hemoclipping [22,23], spraying thrombin [24], and injection of absolute ethanol [23,24]. The endoscopists had chosen the initial hemostatic modality accordingly after appraisal of each individual and alternative hemostatic modalities were chosen when hemostasis had not been achieved.…”

Section: Methodsmentioning

confidence: 99%

“…As to the use of absolute ethanol, it is directly injected in aliquots of 0.1-0.2 mL into areas around the bleeding vessels using an endoscopic local injection needle to a total volume of 1 mL [23,24]. Thrombin spraying is performed as follows: when a clot is covering the ulcer base or when it is adherent to the ulcer base and there is no active bleeding, the endoscopist sprays thrombin into the bleeding ulcer base through the scope to prevent rebleeding [24,26]. …”

Section: Methodsmentioning

confidence: 99%

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Effectiveness of Endoscopic Hemostasis with Soft Coagulation for Non-Variceal Upper Gastrointestinal Bleeding over a 12-Year Period

Yamaguchi

Sakata²,

Yoshida³

et al. 2017

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Background/Aims: In this study, investigations were carried out to ascertain whether soft coagulation hemostasis for non-variceal upper gastrointestinal bleeding (UGIB) has ever been performed in a time-dependent manner. Methods: Medical records of 502 patients who had undergone emergency endoscopic hemostasis for non-variceal UGIB from 2003 to 2014 were checked and the modalities were used to achieve hemostasis compared between the first period from 2003 to 2008 (197 patients) and the second period from 2009 to 2014 (305 patients). Results: Endoscopic hemostasis was successfully achieved in 96.0% of study patients. Peptic ulcers were the main cause of bleeding (89.4%). Endoscopic hemostasis was performed by soft coagulation significantly more frequently during the second (71.1%) than the first period (11.7%; p < 0.001). Endoscopic hemostasis was mainly achieved by trainees during the second period (76.1%); these trainees comprised a significantly greater proportion of endoscopists than during the first period (56.3%; p < 0.001). Endoscopic-related complications did not differ between the 2 periods. The only risk factor for rebleeding after hemostasis was Helicobacter pylori infection; the use of soft coagulation and the fact that endoscopists were just trainees were not risk factors. Conclusion: Our findings suggest that using soft coagulation to achieve endoscopic hemostasis for non-variceal UGIB is safe and effective, even when it is performed by trainees.

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Prevention of recurrent bleeding from gastric ulcer with a nonbleeding visible vessel by endoscopic injection of absolute ethanol: A prospective, controlled trial

Cited by 31 publications

References 27 publications

Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial

Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial

Outcomes of Patients Undergoing Endoscopic Hemostasis for the Upper Gastrointestinal Bleeding Were Not Influenced by the Timing of Hospital Emergency Visits: A Situation Prevailing in Japan

Effectiveness of Endoscopic Hemostasis with Soft Coagulation for Non-Variceal Upper Gastrointestinal Bleeding over a 12-Year Period

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