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KMID : 0359020070340020071
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Korean Journal of Gastrointestinal Endoscopy
2007 Volume.34 No. 2 p.71 ~ p.75
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Clinical Usefulness of Proton Pump Inhibitor Intravenous Treatment in Bleeding Peptic Ulcer
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Lee Hang-Lak
Han Dong-Soo
Sohn Byong-Kwan
Lee Oh-Young
Jeon Yong-Chul
Sohn Joo-Hyun
Yoon Byung-Chul
Choi Ho-Soon
Hahm Joon-Soo
Kim Jin-Bae
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Abstract
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Background/Aims: Recently, high dose PPI intravenous (IV) infusion after endoscopic hemostasis was found to decrease the recurrent bleeding rate. Therefore, we conducted this study to define the effect of endoscopic hemoclipping with PPI IV infusion on the recurrent bleeding rate.
Methods: We conducted a double-blinded prospective randomized control study. A total of 35 patients were endoscopically diagnosed with bleeding peptic ulcer of Forrest classification Ia, Ib, IIa between Jan. 2003 and Sep. 2003 in our hospital. We carried out epinephrine injection therapy around the ulcer, followed by hemoclipping at the exposed vessel. After controlling for endoscopic bleeding, we randomly divided the patients into two groups. One group received a PPI IV infusion (pantoprazole 80 mg/day) and the other group received a placebo for three days.
Results: Only one PPI IV-infused patient and one patient receiving placebo showed recurrent bleeding at two days after endoscopic therapy. The PPI IV infusion group showed 100% (17/17) initial hemostatic rate, 5.8% (1/17) recurrent bleeding rate within 3 days, 0% (0/17) recurrent bleeding rate after 3 days, and 0% (0/17) complication rate. For these same values, the placebo group showed 100% (18/18), 5.5% (1/18), 0% (0/18), and 0% (0/18), respectively.
Conclusions: PPI IV infusion showed no addictive hemostatic effect. We think hemoclipping is a very effective hemostatic method, and PPI IV infusion may not be required after appropriate endoscopic management
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KEYWORD
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Peptic ulcer bleeding, Hemoclipping, Proton pump inhibitor
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