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Title: A randomized trial comparing injection therapy with hemoclip and with injection combined with hemoclip for bleeding ulcers
Authors: Gevers, Anna-Maria ×
De Goede, Eric
Simoens, Marc
Hiele, Martin
Rutgeerts, Paul #
Issue Date: Mar-2002
Series Title: Gastrointestinal Endoscopy vol:55 issue:4 pages:466-9
Abstract: BACKGROUND: A randomized comparative study was conducted of injection therapy with epinephrine-polidocanol (1%) versus hemoclip application, versus injection combined with hemoclip for bleeding peptic ulcers. METHODS: One hundred five patients were randomized and 101 could be evaluated (46 had active spurting or oozing of blood; 55 a visible vessel). Patients were randomized to 1 of the 3 treatment modalities during endoscopy performed within 12 hours of admission. Endoscopy was repeated after 1 day or at recurrence of bleeding and before discharge. In case of recurrent bleeding, patients were retreated with the same modality. RESULTS: Initial failure or the rate of early recurrence of bleeding was highest (but not statistically significant) in the hemoclip group (13/35; 37%), versus the injection (5/34; 15%) and combination (8/32; 25%) groups. Overall failure was significantly (p = 0.01) different among the 3 groups with the highest rate in the hemoclip group (12/35; 34%), versus the injection (2/34; 6%) and combination therapy (8/32; 25%) groups. The use of hemoclips alone appeared to fail because of difficulty with hemoclip placement and incomplete vessel compression. Complications included 1 perforation in the injection group and possibly 1 case of septic arthritis in the combination therapy group. CONCLUSION: In this study, endoscopic treatment of bleeding peptic ulcers with the hemoclip was inferior overall to injection therapy.
URI: 
ISSN: 0016-5107
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Translational Research in GastroIntestinal Disorders
× corresponding author
# (joint) last author

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