Comparison of the Hemostatic Effect of Argon Plasma Coagulation and Heat Probe Coagulation for Peptic Ulcer Bleeding: A Prospective Randomized Trial

Abstract

Bleeding is a serious complication of peptic ulcer. Emergency endoscopy is the most effective diagnostic and therapeutic method in peptic hemorrhage. Endoscopic heat probe coagulation and argon plasma coagulation are considered to be safe and effective in the treatment of bleeding peptic ulcer. The aim of this study was to evaluate the efficacy and safety of argon plasma coagulation and heater probe coagulation in bleeding peptic ulcer. Method: From May 2004 to October 2005 we conducted a prospective randomized trial in 48 patients with peptic ulcer bleeding, in whom a visible vessel or active bleeding was identified. Patients were randomized into two groups, an APC group comprising 24 patients who received argon plasma coagulation (ERBE®, Soering®) and an HP group, comprising 24 patients who received heat probe coagulation(Injection gold probeTM Bipola hemostasis catheters). The bleeding activity was determined according to the Forrest classification. Result: There were no significant differences between the study groups in terms of age, risk factors, initial hemoglobin values, number of patients showing signs of hemodynamic impairment, ulcer location, or bleeding activity. The initial hemostatic rate was 91.7% in the APC group, and 100% in the heat probe group (P = 0.149). After successful initial endoscopic treatment, rebleeding was observed in 2 cases of APC group and 2 cases of heat probe coagulation group, respectively (not significant). Both rebleeding cases were controlled successfully by endoscopic treatment modality. Mean number of hospital days and percentage needing surgery were comparable in both groups. Conclusions: Argon plasma coagulation and heat probe coagulation are equally effective in control of bleeding from peptic ulcer.