Summary
To date several agents have been used to achieve haemostasis in patients with non-variceal upper gastrointestinal bleeding using endoscopic sclerotherapy techniques. Polidocanol has been widely used but local complications have been reported after treatment. We have compared the efficacy and safety of thrombin and polidocanol in 82 consecutive patients with ongoing or recent bleeding from duodenal, gastric, or anastomotic ulcers. Primary control of haemostasis from spurting vessels was achieved in 90% of cases using polidocanol and in 86.6% using thrombin. Definitive haemostasis was obtained in 80% of patients in both groups. When a non-bleeding vessel was visible, injection of polidocanol or thrombin effectively prevented rebleeding in 90.9% and 85.7% of cases, respectively. When a non-bleeding sentinel clot was present, injection of polidocanol or thrombin provided definitive haemostasis in 100% and 92.8% of cases, respectively. No statistically significant difference was evident between the two agents. In the polidocanol group, one local haemorrhagic complication was noted. No general or local complications were recorded in the thrombin group.
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References
Asaki S, Nishimura T, Setoh A, Goto Y (1983) Endoscopic control of gastrointestinal hemorrhage by local injection of absolute ethanol: a basic assessment of the procedure. Tohoku J Exp Med 140: 339–342
Forrest JAH, Finlayson NDC, Shearman DJC (1974) Endoscopy in gastrointestinal bleeding. Lancet II: 394–397
Fuchs KH, Wirtz HJ, Schaube H, Efeldt R (1986) Initial experience with thrombin as injection agent for bleeding gastroduodenal lesions. Endoscopy 18: 146–148
Hajiro K, Matsui H, Tsutimura D (1986) Endoscopic hemostasis with hemoclips, local injection and other new techniques: the Japanese experience. Endoscopy 18 [Suppl 2]: 62–67
Heldwein W, Schreiner J, Pedrazzoli J, Lehnert P (1989) Is the Forrest classification a useful tool for planning endoscopic therapy of bleeding peptic ulcers? Endoscopy 21: 258–262
Hirao M, Kobayashi T, Masuda K (1985) Endoscopic local injection of hypertonic saline epinephrine solution to arrest hemorrhage from the upper gastrointestinal tract. Gastrointest Endosc 31: 313–317
Johnston JH (1984) The sentinel clot and visible vessel: pathologic anatomy of bleeding peptic ulcer. Gastrointest Endosc 30: 313
Leung JW, Chung SCS (1987) Endoscopic injection of adrenalin in bleeding peptic ulcers. Gastrointest Endosc 33: 73–75
Panés J, Viver J, Forne M, Garcia-Olivares E, Marco C, Garan J (1987) Controlled trial of endoscopic sclerosis in bleeding peptic ulcers. Lancet II: 1292–1294
Soehendra N (1987) Endoscopic therapy of upper gastrointestinal bleeding. Endoscopy 18: 205–206
Soehendra N, Grimm H, Stenzel M (1985) Injection of non-variceal bleeding lesions of the upper gastrointestinal tract. Endoscopy 17: 129–132
Worderhoff D, Gros H (1982) Endoscopic haemostasis by injection therapy in high risk patients. Endoscopy 14: 196–199
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Benedetti, G., Sablich, R. & Lacchin, T. Endoscopic injection sclerotherapy in non-variceal upper gastrointestinal bleeding. Surg Endosc 5, 28–30 (1991). https://doi.org/10.1007/BF00591383
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DOI: https://doi.org/10.1007/BF00591383