TITLE

ARGON PLASMA COAGULATION AND ADRENALINE INJECTION FOLLOWED BY INTRAVENOUS PANTOPRAZOLE INFUSION FOR ACUTE BLEEDING PEPTIC ULCER DISEASE—A PRELIMINARY STUDY

AUTHOR(S)
Yap, L.M.; Hagan, S.; Craig, A.; Hebbard, G.S.; Young, G.P.; Bampton, P.A.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA110
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Dual therapy with injection and thermal treatment is regarded as gold standard for treatment of high risk bleeding PUD. Recent work has suggested that high dose IV omeprazole can further reduce rebleeding rate Argon plasma coagulation (APC) has been suggested as modality for applying thermal treatment. Prior to 2001, due to a lack of a heater probe, high risk PUD were managed at FMC and RGH via adrenaline injection alone. Aim: To examine the safety and efficacy of combination treatment with adrenaline injection, argon plasma coagulation (thermal modality), and 48 hours of high dose pantoprazole. Methods: 33 patients enrolled over 15 months were given quadrantic injections of adrenaline 1 in 10 000 with APC applied to the visible vessel followed by IV pantoprazole for 48 hours. Rebleeding, mortality, and surgery rates, transfusion requirements, and length of stay were compared with 33 patients who were treated prior to this trial with adrenaline alone. Results: No complications occurred from the APC. Rebleeding rates were significantly decreased in the combination group (4/3 -12.1% vs 9/33-27.3%, p = 0.025). Transfusion requirements was not significantly reduced but there was a trend for reduction of length (10 to 6 days) of hospital stay. Conclusions: Combination treatment with adrenaline and APC and IV pantoprazole infusion is safe. The results are sufficiently encouraging to warrant a larger trial.
ACCESSION #
9748037

 

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