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Endoscopic treatment for high-risk bleeding peptic ulcers: a comparison of epinephrine alone with epinephrine plus ethanolamine

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Author(s): Anastasios Konstantinidis | Vassilis Valatas | Vassilis Ntelis | Vassilis Balatsos | Ioannis Karoumpalis | Athanasios Hatzinikoloaou | Spilios Manolakopoulos | Irene Vafiadis | Athanasios Archimandritis | Nikolaos Skandalis

Journal: Annals of Gastroenterology
ISSN 1108-7471

Volume: 24;
Issue: 2;
Start page: 101;
Date: 2011;
Original page

ABSTRACT
Background Among the various methods of combined endoscopic therapy for high-risk bleeding peptic ulcers the use of adrenaline followed by injection of ethanolamine is minimally demanding in terms of the endoscopic skills and instrumentation but has not been adequately studied. The aim of the present study is to determine whether the injection of ethanolamine in combination with epinephrine compared to injection of epinephrine alone reduces rebleeding rates, need for surgery and overall mortality of patients with bleeding ulcers.Methods Patients with ulcers and endoscopic features indicative of a high risk for spontaneous recurrent bleeding were included. High risk was defined by the Forrest classification. Patients were assigned to injection of epinephrine alone (n = 284) or epinephrine plus ethanolamine (n = 131).Results Initial hemostasis was achieved in 96% of patients in both groups. We detected significant difference in rates of recurrent bleeding, 16.4% vs. 8.7%, for epinephrine and epinephrine plus ethanolamine respectively (P
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