Endoscopic injection of gelatin solution for severe hemorrhagic gastric cancer

Abstract

Severe bleeding from end-stage gastric cancer is difficult to manage and often fatal. Surgical resection is one option for hemostasis, but many patients cannot tolerate an operation because of their poor condition. Recent advances in endoscopic treatment have introduced various methods to control gastrointestinal bleeding, including pure ethanol injection, hyperosmotic saline-epinephrine injection, and coagulation with a heat probe or laser irradiation. 1 Asaki S Nishiaki T Iwai S et al. Tissue solidification in coping with digestive tract bleeding-hemostatic effect of local injection of 95% ethanol. Gastroenterolical Endoscopy. 1981; 23: 792-798 Google Scholar , 2 Hirao M Kobayashi T Masuda K et al. Endoscopic local injection of hypertonic saline epinephrine solution to arrest hemorrhage from the upper digestive tract. Gastroenterolical Endoscopy. 1981; 23: 1097-1107 Google Scholar , 3 Matek W Fruhmorgen P Kaduk B et al. Modified electro-coagulation and control of gastrointestinal bleeding. Endoscopy. 1971; 11: 253-258 Crossref Scopus (24) Google Scholar , 4 Kiefhaber P Nath G Moritz K. Endoscopical control of massive gastrointestinal hemorrhage by irradiation with a high-power Nd:YAG laser. Prog Surg. 1977; 15: 140-155 Crossref PubMed Google Scholar Although effective for peptic ulcer bleeding, these endoscopic therapies have not been as effective as initially expected for malignancy.