| Popis: |
Patients with bleeding upper gastrointestinal ulcers were observed during the period 1989–1991. The clinical outcome was examined by retrospective analysis. Of all patients with benign gastric or duodenal ulcers, 85 patients presented with stigmata of bleeding, e.g., Forrest grades Ia-IIb. This group was treated endoscopically by the injection of fibrin sealant with or without additional hypertonic saline plus epinephrine. Endoscopic therapeutic procedures were repeated until the ulcers reached Forrest grade III. While initial hemostasis was achieved in all patients, permanent hemostasis declined to 85.9% in our series. The overall bleeding-associated mortality was 7.0%, and in 9.4% continuous bleeding required surgery. No therapy-associated complications were seen. Interestingly, fibrin glue f to induce a rapid healing process. It may be concluded that fibrin sealing is a complication-free highly effective endoscopic therapy. |
