Endoscopic injection therapy using various different agents(ethanol, polidocanol, epinephrine with and without hypertonic saline, etc.) is considered as the least expensive and effective technique to obtain hemostasis in peptic ulcer bleeding,
however
most of these agents induce tissue necrosis or degeneration. Theoretically the injection of fibrin glue in peptic ulcer bleeding may be safer than that of other agents, however, to date, there have been no data from randomized clinical trials on
the
comparison of the efficacies between these agents. To compare the hemostatic efficacy between FG[Beriplast P, Behring, Germany] and HSE[3% saline and epinephrine(1 : 10,000)], we conducted a prospective, randomized, clinical trial among one
hundred
twenty-seven patients with peptic ulcer bleeding from March, 1992 to December, 1993 and in whom a visible or active bleeding was identified. @ES The results were as follows:
@EN 1) They were randomized into two groups [FG group, 64 cases: HSE group, 63 cases].
2) The sources of bleeding in FG group were gastric ulcer in 49 cases and duodenal ulcer in 15 cases, and in HSE group gastric ulcer in 45 cases and duodenal ulcer in 18 cases. As the stigma of bleeding in FG and HSE group, spurting were seen in
18n
cases and 21 cases, oozing in 10 cases and 8 cases and non-bleeding visible vessel in 36 cases and 34 cases, respectively.
3) Permanent hemostasis by only endoscopic treatment was achieved in 59 cases (92.2%) in FG group and in 54 cases(85.7%) in HSE group.
4) The rebleeding was developed in 7 cases(10.9%) in FG group and 14 cases(22.2%) in HSE group, the emergent operation was underwent in 4 cases(6.3%) and 7 cases(11.1%), respectively and the death were noticed in 1 case(1.6%) and 4 cases(6.3%),
respectively.
These results suggest that endoscopic injection of FG is an effective method with better satisfactory hemostatic efficacy than HSE injection in peptic ulcer bleeding.
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