Summary
The introduction of early endoscopic diagnosis has not been associated with a reduction
in either surgical intervention or overall mortality for peptic ulcer hemorrhage.
Recent studies have suggested that endoscopic therapy can reduce rebleeding rates
from peptic ulceration. We report a 2-year experience of the influence of endoscopic
heater probe (HP) (Olympus CD 10Z) therapy on the outcome of patients admitted with
peptic ulcer hemorrhage. Eight hundred and sixty-two patients admitted with peptic
ulcer hemorrhage over a 5-year period (1978/9 and 1983/5) before endoscopic therapy
(PRE-HP), and 263 patients admitted with peptic ulcer hemorrhage after introduction
of endoscopic therapy (POST-HP: 1986-1988) were assessed. All 1,125 patients were
managed by a joint physician/surgeon team. The introduction of HP therapy was associated
with a reduction in surgical intervention and overall mortality rates for gastric
ulceration from 16 % and 8.9 % PRE-HP to 7 % and 2.6 % POST-HP respectively (p < 0.05).
A similar but non-significant trend was noted for duodenal ulceration. The beneficial
effects of HP therapy appear to be due to a reduction in the need for surgical hemostasis
in patients with an ulcer base visible vessel. Our results suggest that a more widespread
use of endoscopic therapy may result in an improved outcome from peptic ulcer hemorrhage.
Key words:
Peptic ulcer - Surgery - Therapeutic endoscopy
