Implementation of new techniques in the management of upper gastrointestinal bleeding

Abstract

Background: In recent years, many endoscopic hemostasis techniques helped to improve the prognosis of upper gastrointestinal bleeding. It includes: esophageal band ligation and Histoacryl injection in variceal upper GI bleeding; dilute adrenalin injection, hemoclipping, argon plasma coagulation and Hemospray in non-variceal upper GI bleeding. But domestic studies about these techniques’ efficacy are limited. Objectives: 1. To describe characteristics of patients and endoscopic lesions in upper GI bleeding. 2. To assess the efficacy of some endoscopic hemostasis techniques in upper GI bleeding. Subject and methods: Interventional study concluded 346 upper GI bleeding patients, 365 therapeutic upper endoscopy to get hemostasis in Gastroenterology - Endoscopy Center, Hue University of Medicine and Pharmacy Hospital from 11/2017 to 4/2022. Result: Mean age of patients is 55.6 ± 17.9, minimum is 9, maximum is 95. Male/female ratio is 2.5. The causes of bleeding: esophageal varices 35.5%, gastric varices 4.3%, peptic ulcer diseases 50.9%, esophago-gastric junction tear 5.5%, angiodysplasia 2.6%, and others 1.2%. Hemostatic techniques: esophageal band ligation 33.7%, Histoacryl injection 4.1%, hemoclipping 52.6%, dilute adrenalin injection 15.9%, APC 7.9%, Hemospray 0.8% and others 0.3%. Successful rate of initiating endoscopic hemostasis is high (100%), permanent hemostasis is high (99.1%); recurrent bleeding rate is low (2.3%), endoscopic hemostasis failure is low (0.9%); operation rate is low (0.9%). Conclusion: Endoscopic hemostasis techniques showed good safety and efficacy, failure and operation rate are very low. Using new techniques in case of failure of traditional techniques was beneficial and safe Key words: upper gastrointestinal bleeding, endoscopy