Korean Journal of Gastrointestinal Endoscopy 1999;19(3): 337-346.
소화성 궤양 출혈에 대한 내시경적 순수에탄올 국소주사요법의 치료 효과 및 예후 ( The Hemostatic Effect and Prognosis of Endoscopic Ethanol Injection in Bleeding Peptic Ulcer )
이동호, 이국래, 김태호, 이진혁, 박민정, 최일주, 이경미, 김유선, 김주성, 김용태, 정현채, 윤용범, 송인성, 김정룡 (Dong Ho Lee, Kuk Lae Lee, Tae Ho Kim, Jin Hyuk Lee, Min Jung Park, Il Joo Choi, Kyeong Mi Lee, You Sun Kim, Joo Sung Kim, Yong Tae Kim, Hyun Chae Chung, Yong Bum Yoon, In Sung Song and Chung Yong Kim)
Abstract
Background/Aims: Endoscopic injection therapy improves the outcome in bleeding peptic ulcer, but the optimum regimen is unknown. Although endoscopic injection therapy is effective in controlling initial hemorrhage from a peptic ulcer, between 10% to 30% of patients suffer rebleeding. The aim of this study was to evaluate the initial and ultimate success rate of hemostasis, the rebleeding rate, hospital stay (days), and the emergency operation rate in patients who had undergone endoscopic ethanol injection for bleeding peptic ulcer. Methods: Thirty nine patients presented with active bleeding (spurting), visible vessels, or blood clots on endoscopic findings were given an endoscopic ethanol injection with a total of 1.0∼3.0 ml of ethanol. The initial and ultimate success rate of hemostasis, rebleeding rate, and emergency operation rate after the endoscopic injection was evaluated. Results: 1) The initial success of hemostasis was 38/39 (97.4%). 2) The rebleeding rate after ethanol injection was 8/39 (20.5%). 3) The success rate of the second trial of ethanol injection was 3/8 (37.8%). 4) Emergency operations were conducted in5/39 (12.8%). 5) The ultimate success rate of hemostasis was 34/39 (87.2%). 6) There were no mortalities [0/39 (0%)] related to the ethanol injections and bleeding peptic ulcers. 7) There were no complications [0/39 (0%)] related to the ethanol injections. 8) The mean duration of hospitalization was 9.5 4.5 days. Conclusions: Endoscopic ethanol injection in the treatment of bleeding peptic ulcers was as effective and safe as any other injection or mechanical hemostatic method. Further prospective studies or endoscopic trials for hemostasis are needed to reduce the rebleeding rate and emergency operation rate of bleeding peptic ulcer. (Korean J Gastrointest Endosc 19: 337∼346, 1999)
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