Nobuhiro Dan*, Kazuhisa Yamaguchi, Takafumi Otsuka, Kazuhiro Fuchinoue, Kazunori Hijikata, Tomoko Kobayashi, Yoshiro Yamamoto, Takahito Toba, Yoshinori Kikuchi and Yoshinori Igarashi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, JapanFulltext PDF
Abstract Objective: To conduct a comparative study of changes in terms of the endoscopic hemostasis methods used over the past 10 years and patient characteristics, in cases of Gastroduodenal ulcer treated by emergency upper gastrointestinal endoscopy in our hospital. Methods: Patients who had undergone emergency upper gastrointestinal endoscopy in our hospital from January 2004 to December 2006 and January 2014 to December 2016 were categorized into Group A and Group B, respectively, based on the time period. The two groups were compared retrospectively by extracting the patient characteristics, hemostasis method, and various risk factors. Results: The number of cases that required hemostatic treatment tended to decrease with time (138 cases vs. 75 cases). The mean age of patients increased in Groups A and B (59.4 years vs. 66.7 years, p<0.01). Helicobacter pylori infection rate showed a slight declining tendency (90.0% vs. 85.0%, p=0.33), but there was an increase in the number of patients taking oral nonsteroidal antiinflammatory drugs (17.0% vs. 36.0%, p<0.01) and oral antithrombotic agents (12.0% vs. 23.0%, p=0.02).The endoscopic clipping method was reduced (67.0% vs. 29.0%, p<0.01). The number of local ethanol injections decreased markedly (40.0% vs. 4.0% p<0.01). However, there was a marked increase in the number of cases subjected to cauterization using hemostatic forceps (4.0% vs. 80.0%, p<0.01). Conclusion: While changes that took place over time did not affect H. pylori infection, cases treated using local injections of ethanol or clipping decreased in number, whereas cases subjected to hemostasis methods using high-frequency coagulation increased.
Dan N, Yamaguchi K, Otsuka T, Fuchinoue K, Hijikata K, Kobayashi T, et al. Study of Hemorrhagic Gastroduodenal Ulcers Treated by Emergency Endoscopic Hemostasis: Comparison between the Current Situation and that before 10 Years. Clin Surg. 2019; 4: 2612..