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Epinephrine plus argon plasma or heater probe coagulation in ulcer bleeding
Ahmet Karaman1, Mevlut Baskol, Sebnem Gursoy
1Department of Gastroenterology, Erciyes University, 38030 Kayseri, Turkey. drkaraman@hotmail.com
World Journal of Gastroenterology
|November 1, 2011
Summary
Argon plasma coagulation (APC) showed higher initial success rates for stopping non-variceal upper gastrointestinal bleeding compared to heater probe coagulation (HPC). Further trials are needed to confirm these findings for bleeding peptic ulcers.
Area of Science:
- Gastroenterology
- Endoscopy
- Medical Devices
Background:
- Non-variceal upper gastrointestinal bleeding is a significant clinical concern.
- Effective endoscopic hemostasis is crucial for managing bleeding peptic ulcers.
Purpose of the Study:
- To compare the efficacy of argon plasma coagulation (APC) and heater probe coagulation (HPC) in achieving hemostasis for non-variceal upper gastrointestinal bleeding.
- To evaluate initial hemostasis and rebleeding rates between APC and HPC.
Main Methods:
- A randomized study involving 85 patients with acute gastrointestinal bleeding from gastric or duodenal ulcers.
- Upper endoscopy was performed, with random assignment to either APC or HPC for bleeding control.
- Primary endpoint: initial hemostasis; Secondary endpoint: rebleeding rates.
Main Results:
- Argon plasma coagulation (APC) achieved significantly higher initial hemostasis rates (97.7%) compared to heater probe coagulation (HPC) (81%) (P < 0.05).
- Rebleeding rates at 4 weeks were lower in the APC group (2.4%) than in the HPC group (8.3%), though not statistically significant (P > 0.05).
Conclusions:
- Argon plasma coagulation (APC) is an effective endoscopic hemostatic method for bleeding peptic ulcers.
- Larger multicenter trials are recommended to validate these findings and further establish APC's role.
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