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Endoscopic bipolar electrocoagulation in massive upper gastrointestinal bleeding.

K Hajiro, H Matsui, D Tsujimura

    Gastroenterologia Japonica
    |February 1, 1985
    PubMed
    Summary
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    Endoscopic bipolar electrocoagulation (BPEC) effectively stops massive upper gastrointestinal bleeding in 94% of cases. While rebleeding occurs in some patients, BPEC reduces transfusions and avoids surgery, offering a valuable alternative to operations.

    Area of Science:

    • Gastroenterology
    • Endoscopic interventions
    • Hemorrhage control

    Background:

    • Massive upper gastrointestinal bleeding poses significant management challenges.
    • Surgical intervention carries high risks for critically ill patients.
    • Endoscopic therapies are increasingly explored for hemostasis.

    Purpose of the Study:

    • To evaluate the efficacy of endoscopic bipolar electrocoagulation (BPEC) in managing massive upper gastrointestinal bleeding.
    • To assess the hemostatic success and rebleeding rates associated with BPEC.
    • To determine the impact of BPEC on transfusion requirements, need for surgery, and patient outcomes.

    Main Methods:

    • Retrospective review of 50 cases of massive upper gastrointestinal bleeding treated with BPEC.

    Related Experiment Videos

  • Analysis of initial hemostasis rates, rebleeding rates, and associated patient factors.
  • Evaluation of mortality, blood transfusion volumes, and need for emergency surgery.

    • Main Results:

    • Initial hemostasis was achieved in 94% of patients.
    • Overall rebleeding rate was 19.1%, with higher rates in patients needing >2,000 ml transfusions (47.3%) and those with acute gastric mucosal lesions (AGML) (35.3%).
    • Mortality directly from bleeding was 33.3% in massive bleeders and 22.2% in AGML cases; overall mortality was 38%.

    Conclusions:

    • Endoscopic bipolar electrocoagulation is an effective emergency hemostatic method for massive upper gastrointestinal bleeding.
    • BPEC serves as a viable alternative to surgical intervention, reducing transfusion needs and avoiding operations.
    • While BPEC may not alter fatal outcomes in all massive bleeding cases, it improves patient management and prolongs survival.