Abstract
Abstract: A prospective, randomized trial was performed to compare the efficacy of Nd: YAG laser photocoagulation (LP) and absolute ethanol injection therapy (AEIT) in the treatment of peptic ulcer bleeding. Of 396 patients who underwent endoscopy for acute gastrointestinal hemorrhage over a 18‐month period, 185 were found to have peptic ulcers. The patients who had an ulcer with active bleeding (n = 25) or with a nonbleeding visible vessel (n = 35) were randomized to receive either LP (n = 29) or AEIT (n = 31). The two treatment groups were comparable in terms of age, severity of bleeding, site of ulcer, and endoscopic stigmata of recent hemorrhage. There were no significant differences between the LP and AEIT groups in terms of their transfusion requirements after treatment (0.6 ±1.0 vs. 0.5±0.9 unit), rate of initial hemostatic failure or rebleeding (13.8 vs. 9. 7%), emergency surgery (0 vs. O%), median hospital stay (6 us. 8 days), and mortality (0 us. 6.5%). All of the seven patients who rebled received a second session of endoscopic therapy with the other modality and bleeding was controlled. The cause of death in the two expired patients was not related to bleeding. We concluded that LP and AEIT are equally effective in the treatment of peptic ulcer bleeding but AEIT may be preferred over LP because of its simplicity and lower cost.
Published Version
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