EFFICACY OF INITIAL AND PERMANENT HEMOSTASIS OF THE ENDOSCOPIC HEMOCLIP METHOD COMBINED WITH HIGH-DOSE INFUSION OF PROTON PUMP INHIBITOR IN PATIENTS WITH PEPTIC ULER BLEEDING

2018 ◽  
pp. 15-21
Author(s):  
Hieu Tam Huynh ◽  
Dang Quy Dung Ho
Keyword(s):  
Peptic Ulcer ◽  
Success Rate ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
Injection Sclerotherapy ◽  
High Dose ◽  
Peptic Ulcers ◽  
Peptic Ulcer Bleeding ◽  
Bleeding Peptic Ulcers ◽  
Hemostatic Therapy

Background: Peptic ulcer bleeding is one of the common medical emergencies. The hemostatic efficacy of endoscopic therapeutic modalities has been reported in many studies and frequently has been found to exceed 90%. Four groups of modalities are used in the endoscopic management of bleeding peptic ulcers: thermal probe methods, injection sclerotherapy, local spray methods, and mechanical hemostatic therapy. The endoscopic hemoclip method is a safe and effective hemostatic therapy for managing bleeding peptic ulcers. Objective: To determine the success rate of hemoclip in endoscopic hemostasis. Patients and methods: Clinical intervention study on 36 patients with peptic ulcer bleeding admitted in Can Tho Central General Hospital from May 2012 to November 2014. All the patients underwent emergency endoscopy for hemostasis by hemoclip and high-dose PPI use. Results: The success rate of initial hemostasis was 97.2%, and permanent hemostasis was 91.7%. The rates of rebleeding, surgery, mortality were 11.1%, 5.6%, 2.8%, respectively. Conclusion: Endoscopic hemostasis therapy by clipping combined with high- dose PPI is an effective, relatively safe treatment for peptic ulcer bleeding. Key words: Peptic ulcer bleeding, hemoclip, endoscopic hemostasis therapy

EFFICACY OF ENDOSCOPIC INJECTION THERAPY WITH HSE 3% COMBINED WITH HIGH-DOSE PROTON PUMP INHIBITOR IN PEPTIC ULCER BLEEDING

2014 ◽  
pp. 36-39
Author(s):  
Hieu Tam Huynh ◽  
Trong Thang Hoang
Keyword(s):  
Peptic Ulcer ◽  
Success Rate ◽  
Cross Sectional Study ◽  
Endoscopic Hemostasis ◽  
High Rate ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Peptic Ulcer Bleeding ◽  
Endoscopic Injection ◽  
Cross Sectional

Background: Peptic ulcer bleeding is one of the common medical emergencies with a high rate of mortality. Endoscopic hemostasis with HSE 3% injection is an effective treatment for patients with peptic ulcer bleeding, helps to save cost and avoid an unnecessary emergency surgery. Objective: To determine the success rate of endoscopic hemostatic with HSE 3% injection in patients with peptic ulcer bleeding. Patients and methods: A prospective, cross sectional study on 41 patients with peptic ulcer bleeding admitted in Can Tho Central General Hospital, from August 2012 to April 2013. All the patients underwent emergency endoscopy for hemostasis by injecting HSE 3% solution, and high- dose PPI use. Results: The rate of Forrest class IA, IB, IIA, IIB was 12.2%, 56.1%, 19.5% and 12.2%, respectively. The rate active bleeding group (Forrest class IA/IB) was 668.3%, while hemostatic group with high risk of rebleeding was 31.7%. The success rate was 92.7%, and the rebleeding rate was 7.3%. Conclusion: Endoscopic HSE 3% injection combined with high- dose PPI is an effective, relatively safe treatment for peptic ulcer bleeding. Key words: peptic ulcer bleeding, HSE, endoscopic hemostasis therapy.

scholarly journals High- versus low-dose proton pump inhibitors post endoscopic hemostasis in hemodialysis cases with peptic ulcer bleeding

2021 ◽  
Vol 84 (1) ◽  
pp. 3-8
Author(s):  
AA Salman ◽  
MA Salman ◽  
MD Sarhan ◽  
H El-Din Shaaban ◽  
M Yousef ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Dose Group ◽  
Low Dose ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Recurrent Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Risk Patients ◽  
Regular Hemodialysis

Post-endoscopic hemostasis treatment is not adequately addressed in high-risk patients on regular hemodialysis (HD) with emergency peptic ulcer bleeding. This study aimed to compare post-endoscopic high- versus low-dose proton pump inhibitors (PPIs) for peptic ulcer bleeding in patients undergoing regular HD. This prospective study comprised 200 patients on regular hemodialysis having emergency peptic ulcer bleeding confirmed at endoscopy and managed with endoscopic hemostasis. Half of the patients received high-dose intensive regimen and the other half received the standard regimen. Patients who were suspected to have recurrent bleeding underwent a second endoscopy for bleeding control. The primary outcome measure was rate of recurrent bleeding during period of hospitalization that was detected through second endoscopy. Rebleeding occurred in 32 patients ; 15 in the High-Dose Cohort and 17 in the Low-Dose Control (p = 0.700). No significant differences between the two dose cohorts regarding the time of rebleeding (p = 0.243), endoscopic hemostasis mode (p = 1.000), and need for surgery (p = 0.306). The high-dose regimen In-hospital mortality in high-dose group was 9.0% compared to 8.0% in the low-dose group (p = 0.800). Apart from the pre-hemostatic Forrest classification of ulcers, there were no significant differences between patients with re-bleeding ulcers (n=32) and those with non-rebleeding (n=168). Rebleeding was more common in class Ia, i.e. spurting bleeders (p < 0.001). Endoscopic hemostasis followed by the standard low-dose PPI regimen of 40 mg daily IV boluses is safe and effective option for bleeding peptic ulcers in the high-risk patients under regular hemodialysis.

scholarly journals Recent advances in the management of peptic ulcer bleeding

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1763 ◽  
Author(s):  
Ian Beales
Keyword(s):  
Peptic Ulcer ◽  
Accurate Determination ◽  
Gastrointestinal Haemorrhage ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Peptic Ulcers ◽  
Peptic Ulcer Bleeding ◽  
Endoscopic Techniques ◽  
Recent Advances ◽  
Proton Pump Inhibition

Acute upper gastrointestinal haemorrhage due to peptic ulcer bleeding remains an important cause of emergency presentation and hospital admission. Despite advances in many aspects of management, peptic ulcer bleeding is still associated with significant morbidity, mortality, and healthcare costs. Comprehensive international guidelines have been published, but advances as well as controversies continue to evolve. Important recent advances include the evidence supporting a more restrictive transfusion strategy aiming for a target haemoglobin of 70–90 g/l. Comparative studies have confirmed that the Glasgow–Blatchford score remains the most useful score for predicting the need for intervention as well as for identifying the lowest-risk patients suitable for outpatient management. New scores, including the AIMS65 and Progetto Nazionale Emorragia Digestiva score, may be more accurate in predicting mortality. Pre-endoscopy erythromycin appears to improve outcomes and is probably underused. High-dose oral proton pump inhibition (PPI) for 11 days after PPI infusion is advantageous in those with a Rockall score of 6 or more. Oral is as effective as parenteral iron at restoring haemoglobin levels after a peptic ulcer bleed and both are superior to placebo in this respect. Within endoscopic techniques, haemostatic powders and over-the-scope clips can be used when other methods have failed. A disposable Doppler probe appears to provide more accurate determination of both rebleeding risk and the success of endoscopic therapy than purely visual guidance. Non-Helicobacter pylori, non-aspirin/non-steroidal anti-inflammatory drug ulcers contribute an increasing percentage of bleeding peptic ulcers and are associated with a poor prognosis and high rebleeding rate. The optimal management of these ulcers remains to be determined.

Bolus Versus Continuous High-Dose Omeprazole Infusion Combined with Endoscopic Hemostasis in Peptic Ulcer Bleeding. A Randomized, Multicenter, Italian Study

2007 ◽  
Vol 65 (5) ◽  
pp. AB120 ◽  
Author(s):  
Angelo Andriulli ◽  
Silvano Loperfido ◽  
Rosaria Focareta ◽  
Pietro Leo ◽  
Fabio Fornari ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Peptic Ulcer Bleeding ◽  
Italian Study

scholarly journals Surgical perspectives in treatment of bleeding peptic ulcers

2007 ◽  
Vol 54 (1) ◽  
pp. 157-164
Author(s):  
Z.D. Lausevic ◽  
P.M. Pesko ◽  
S.N. Krstic ◽  
A. Sijacki ◽  
M.S. Gvozdenovic ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Ulcer Bleeding ◽  
Peptic Ulcers ◽  
Peptic Ulcer Bleeding ◽  
Lethal Outcome ◽  
Bleeding Peptic Ulcers ◽  
Bleeding Ulcers ◽  
Endoscopic Diagnostics ◽  
Overall Mortality

Peptic ulcer bleeding has overall incidence of 50 to 150 on 100.000 grown-ups per year and represents cause for over 1% of all urgent hospitalization today. Despite of the evolution of the endoscopic diagnostics and haemostasis, improved intensive care and surgical treatment, overall mortality is still over 10% (operative treatment over 20%), and it almost hasn?t changed over past 40 years. For more than 100 years surgery had major role in treatment of peptic bleeding ulcers, whereas nowadays it is limited to treatment of its complications. Adequate surgical treatment demands properly timed operation, safest but appropriate operation and trained surgeon. Early surgery is much better compared to the last minute surgery. At high risk rebleeding ulcer, early delayed surgery appears to be adequate, since the complications and lethal outcome are more frequent in this group.

STUDY THE EFFICACY OF HEMOCLIP IN ENDOSCOPIC HEMOSTASIS COMBINED WITH HIGH-DOSE INFUSION OF PROTON-PUMP INHIBITOR IN PATIENTS WITH PEPTIC ULCER BLEEDING

2014 ◽  
pp. 30-33
Author(s):  
Hieu Tam Huynh ◽  
Trong Thang Hoang
Keyword(s):  
Peptic Ulcer ◽  
Cross Sectional Study ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Peptic Ulcer Bleeding ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Type Ia ◽  
Rebleeding Rate

Background: Peptic ulcer bleeding is one of the common emergency cases in gastroenterology, the mortality rate is high. The study of the effecacy of hemoclip in endoscopic hemostasis therapy that helps to give an effective method for treatment peptic ulcer bleeding, to save cost for patients, to avoid a surgery that is serious for these patients. Objective:(i) To determine the prevalence of peptic ulcer bleeding with high risk of rebleeding (FIA, FIB and FIIA) according to Forrest classification; (ii) To determine effecacy of hemoclip in endoscopic hemostasis in patients with peptic ulcer bleeding. Patients and methods:A cross sectional study on 22 patients with peptic ulcer bleeding in Can Tho Center General Hospital during May 2012 to October 2013. Results:The rate of active bleeding group (Forrest type IA and IB) and visible vessel group (Forrest type FIIA) were 50% and 50%. Hemostatic rate by clipping was 95.5%, and the rebleeding rate was only 9.1%; the rate of emergent surgery and mortality were 4.5% and 4.5%. Conclusion:Endoscopic hemoclip treatment for bleeding due to peptic ulcer is an effective and safe method. The percentage of success was high 95.5%. The rebleeding rate was low, only 9.1%. The number of patients haved been operated and the dead rate were low, only 4.5%. Key words: Peptic ulcer bleeding, hemoclip, endoscopic hemostasis therapy

High-Dose Pantoprazole Continuous Infusion Is Superior to Somatostatin After Endoscopic Hemostasis in Patients With Peptic Ulcer Bleeding

2007 ◽  
Vol 102 (6) ◽  
pp. 1192-1199 ◽  
Author(s):  
Panagiotis Tsibouris ◽  
Elias Zintzaras ◽  
Christos Lappas ◽  
Maria Moussia ◽  
George Tsianos ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Continuous Infusion ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
High Dose ◽  
Peptic Ulcer Bleeding
Sign in / Sign up

Export Citation Format

Share Document