Korean J Gastrointest Endosc.  2006 Apr;32(4):239-245.

Controlled Comparison of Endoscopic Epinephrine Injection and Endoscopic Argon Plasma Coagulation for the Treatment of Acute Peptic Ulcer Bleeding

• Pae KI
• Lee SH
• Kim H
• Lee SB
• Lee JH
• Park SJ
• Jee SR
• Park ET
• Lee YJ
• Seol SY
• Chung JM

Abstract

BACKGROUND/AIMS: Endoscopic injection therapy with hypertonic saline Epinephrine (HSE) is the easiest and most widely used procedure for the management of peptic ulcer bleeding. Argon plasma coagulation (APC) is a recently introduced endoscopic hemostatic procedure. Thus, we performed a prospective trial to compare the hemostatic efficacy of APC and HSE.
METHODS
Forty patients with the diagnosis of bleeding ulcer were randomly assigned to receive either HSE (n=20) or APC (n=20) treatment during the period of September 2003 to April 2004. The two groups were matched for gender, age, site of bleeding, the endoscopic findings and the initial hemoglobin at the study baseline.
RESULTS
The bleeding was initially controlled in 18 patients (90%) of the APC group, and in 20 patients (100%) of the HSE group. Rebeeding occurred in one patient (5%) of the APC group and in 3 patients (15.5%) of the HSE group. The lengths of stay in the hospital were 11.7 days in the APC group and 10.7 days in the HSE group. Death occurred in 1 case in the APC group and in 1 case in the HSE group. The initial hemostatic efficacy showed no difference between the two groups.
CONCLUSIONS
Argon plasma coagulation is as effective as hypertonic saline epinephrine injection for the initial management of acute peptic ulcer bleeding.

Keyword

Argon plasma coagulation; Hypertonic saline epinephrine; Peptic ulcer bleeding

MeSH Terms

Argon Plasma Coagulation*
Argon*
Diagnosis
Epinephrine*
Hemorrhage*
Humans
Peptic Ulcer*
Prospective Studies
Ulcer
Argon
Epinephrine