The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
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Background/Aims: Peptic ulcer bleeding is the most common cause of upper gastrointestinal tract bleeding. Platelet-rich plasma(PRP) enhances tissue repair, and is therefore used in various medical treatments. A combination of mechanical or electrothermalhemostasis has been recommended for upper gastrointestinal tract bleeding treatment. This study evaluated the additive efficacy ofPRP in bleeding peptic ulcer hemostasis and recovery. Methods: Eighty patients with peptic ulcer bleeding were initially treated by hemoclipping, and were randomly chosen for eitheradditional PRP (n=40) or additional epinephrine (n=40) injections. Both groups were compared with regard to achieving hemostasisand the frequency of complications. Results: Hemostasis was immediately achieved in both groups. Two patients (5%) in the PRP group and 8 (20%) patients in theepinephrine group experienced rebleeding after 15.9±2.8 and 12.3±3.7 days, respectively. They were managed by PRP injection inaddition to proton pump inhibitor infusion. Hemoglobin was substantially increased in the PRP-treated group with full recoveryoccurring in 60.5% compared to 31.3% of patients in the epinephrine group (p=0.001). There was no recurrent bleeding in the PRPgroup, but 4/32 (12.5%) patients in the epinephrine group exhibited rebleeding. Conclusions: PRP showed additional benefit in reducing peptic ulcer bleeding with no reported significant complications. Clinicaltrial (NCT03733171).
Abstract
Background/Aims: Peptic ulcer bleeding is the most common cause of upper gastrointestinal tract bleeding. Platelet-rich plasma(PRP) enhances tissue repair, and is therefore used in various medical treatments. A combination of mechanical or electrothermalhemostasis has been recommended for upper gastrointestinal tract bleeding treatment. This study evaluated the additive efficacy ofPRP in bleeding peptic ulcer hemostasis and recovery. Methods: Eighty patients with peptic ulcer bleeding were initially treated by hemoclipping, and were randomly chosen for eitheradditional PRP (n=40) or additional epinephrine (n=40) injections. Both groups were compared with regard to achieving hemostasisand the frequency of complications. Results: Hemostasis was immediately achieved in both groups. Two patients (5%) in the PRP group and 8 (20%) patients in theepinephrine group experienced rebleeding after 15.9±2.8 and 12.3±3.7 days, respectively. They were managed by PRP injection inaddition to proton pump inhibitor infusion. Hemoglobin was substantially increased in the PRP-treated group with full recoveryoccurring in 60.5% compared to 31.3% of patients in the epinephrine group (p=0.001). There was no recurrent bleeding in the PRPgroup, but 4/32 (12.5%) patients in the epinephrine group exhibited rebleeding. Conclusions: PRP showed additional benefit in reducing peptic ulcer bleeding with no reported significant complications. Clinicaltrial (NCT03733171).
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