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Endoscopic treatment of peptic ulcer bleeding

Traitement endoscopique des hémorragies sur ulcère

Tratamiento endoscopico de las hemorragias por ulcus

  • Published:
Acta Endoscopica

Summary

The modality for endoscopic hemostasis of severe ulcer bleeding best studied is Neodymium-Yag laser photocoagulation. It has been shown that this treatment significantly reduces the duration of bleeding, the risk for rebleeding, indications for emergency surgery and in some series even mortality. The laser apparatus, however, is expensive. Other simple and inexpensive methods have been developped including the other thermal modalities, bipolar electrocoagulation and heater probe as well as different injection methods. The current status of endoscopie hemostasis for peptic ulcer bleeding is discussed.

RÉSUMÉ

Le mode d’hémostase endoscopique le mieux étudié dans les hémorragies sévères sur ulcère est la photocoagulation au laser Neodymium-YAG. Il a été démontré que ce traitement diminue de façon significative la durée du saignement, le risque de récidive hémorragique, les indications de la chirurgie en urgence et même, dans certaines séries, le taux de mortalité. Néanmoins, l’instrumentation laser est coûteuse. d’autres méthodes simples et peu onéreuses ont été mises au point, comportant des modes de traitement thermiques, électrocoagulation bipolaire, la sonde de type « heater probe » et différentes méthodes d’injection. La présente revue discute l’état actuel de l’hémostase endoscopique dans les ulcères hémorragiques.

Resumen

El método de hemostasia mejor estudiado en las hemorragias graves por úlcera es el de la fotocoagulación con laser Neodymium-YAG. Se ha demostrado que éste tratamiento disminuye de manera significativa la duración de la hemorragia, el riesgo de recidiva, el número de intervenciones de urgencia y, en algunas series, la tasa de mortalidad. Sin embargo, el láser es muy costoso. Es por ello que se han experimentado otros métodos más simples y poco costosos, que comportan el empleo de sondas térmicas, electrocoagulación bipolar, sonda tipo « heater-probe » y diversos métodos de inyección. Esta revisión discute el estado actual de la hemostasia endoscópica en las úlceras hemorrágicas.

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  1. University of Leuwen, (Belgium)

    J. Van Isveldt, P. Rutgeerts & G. Vantrappen

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Van Isveldt, J., Rutgeerts, P. & Vantrappen, G. Endoscopic treatment of peptic ulcer bleeding. Acta Endosc 18, 279–290 (1988). https://doi.org/10.1007/BF02966269

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