How Can We Maximize Skills for Non-Variceal Upper Gastrointestinal Bleeding: Injection, Clipping, Burning, or Others?
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초록
Endoscopy has its role in the primary diagnosis and management of acute non-variceal upper gastrointestinal bleeding. Main roles of endoscopy are identifying high risk stigmata lesion, and performing endoscopic hemostasis to lower the rebleeding and mortality risks. Early endoscopy within the first 24 hours enables risk classification according to clinical and endoscopic criteria, which guide safe and prompt discharge of low risk patients, and improve outcomes of high risk patients. Techniques including injection therapy, ablative therapy and mechanical therapy have been studied over the recent decades. Combined treatment is more effective than injection treatment, and single treatment with mechanical or thermal method is safe and effective in peptic ulcer bleeding. Specific treatment and correct decisions are needed in various situations depending on the site, location, specific characteristics of lesion and patient’s clinical conditions.
Abstract
Endoscopy has its role in the primary diagnosis and management of acute non-variceal upper gastrointestinal bleeding. Main roles of endoscopy are identifying high risk stigmata lesion, and performing endoscopic hemostasis to lower the rebleeding and mortality risks. Early endoscopy within the first 24 hours enables risk classification according to clinical and endoscopic criteria, which guide safe and prompt discharge of low risk patients, and improve outcomes of high risk patients. Techniques including injection therapy, ablative therapy and mechanical therapy have been studied over the recent decades. Combined treatment is more effective than injection treatment, and single treatment with mechanical or thermal method is safe and effective in peptic ulcer bleeding. Specific treatment and correct decisions are needed in various situations depending on the site, location, specific characteristics of lesion and patient’s clinical conditions.
참고문헌 (11)
- van Leerdam ME, "Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993", 1994 and 2000, 2003, pp.98, 1494~1499
- Barkun AN, "Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses", Gastrointest Endosc, 69, pp.786~799 (2009)
- Sung JJ, "Endoscopic clipping versus injection and thermo-coagulation in the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis", Gut, 56, pp.1364~1373 (2007)
- Lau JY, "Omeprazole before endoscopy in patients with gastrointestinal bleeding", N Engl J Med, 356, pp.1631~1640 (2007)
- Sung JJ, "The effect of endoscopic therapy in patients receiving omeprazole for bleeding ulcers with nonbleeding visible vessels or adherent clots: a randomized comparison", Ann Intern Med, 139, pp.237~243 (2003)
- Chiu PW, "Endoscopic plication of massively bleeding peptic ulcer by using the Eagle Claw VII device: a feasibility study in a porcine model", Gastrointest Endosc, 63, pp.681~685 (2006)
- Peter S, "Endoscopic Therapy for peptic ulcer bleeding", Front Gastrointest Res, 27, pp.37~54 (2010)
- Yuan Y, "Endoscopic clipping for acute nonvariceal upper-GI bleeding: a meta-analysis and critical appraisal of randomized controlled trials", Gastrointest Endosc, 68, pp.339~351 (2008)
- Marmo R, "Dual therapy versus monotherapy in the endoscopic treatment of high-risk bleeding ulcers: a meta-analysis of controlled trials", Am J Gastroenterol, 102, pp.279~289 (2007)
- Sung JJ, "Nanopowders are highly effective in achieving hemostasis in severe peptic ulcer bleeding: an interim report of a prospective human trial", Gastrointestinal Endoscopy, 71, pp.198~ (2010)
- Laine L, "Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials", Clin Gastroenterol Hepatol, 7, pp.33~47 (2009)