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Current managements and outcomes of peptic and artificial ulcer bleeding in Japan

Mitsuhiro Fujishiro1, Nobutsugu Abe, Masaki Endo

  • 1Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|July 2, 2010
PubMed

Insights

This study shows endoscopic treatments for peptic and artificial ulcer bleeding in Japan are highly effective, with similar excellent outcomes. Management strategies for these gastroduodenal ulcers varied slightly but resulted in successful hemostasis and low rebleeding rates.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Internal Medicine

Background:

  • Gastroduodenal ulcer bleeding trends in Japan, particularly artificial ulcers, require detailed elucidation.
  • Current management and outcomes for peptic and artificial ulcer bleeding are not well-defined.

Purpose of the Study:

  • To investigate current management strategies and outcomes for peptic and artificial ulcer bleeding in Japan.
  • To compare the efficacy of endoscopic treatments for these two types of gastroduodenal ulcers.

Main Methods:

  • A retrospective, multicenter study of 325 patients with nonmalignant gastroduodenal ulcer bleeding.
  • Data collected included hemostasis success rates, rebleeding, surgical intervention, death, endoscopic methods, and second-look endoscopy timing.
  • Patients were treated between January 2008 and December 2008 at nine high-volume Japanese hospitals.

Main Results:

  • Successful initial hemostasis was achieved in 99.1% of peptic ulcer patients and 100% of artificial ulcer patients.
  • Rebleeding rates were 10.1% for peptic ulcers and 11.9% for artificial ulcers.
  • No deaths were observed; surgical rescue was required in only a few cases. Differences noted in endoscopic methods and second-look endoscopy frequency.

Conclusions:

  • Endoscopic treatment for nonmalignant gastroduodenal bleeding in Japan yields excellent outcomes for both peptic and artificial ulcers.
  • While overall efficacies are similar, minor variations exist in endoscopic techniques, medication use, and the application of second-look endoscopy.
  • The study highlights the effectiveness of current endoscopic interventions for gastroduodenal bleeding in Japan.

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