THERAPEUTIC ENDOSCOPY OUTCOMES IN UPPER GI PEPTIC ULCER BLEEDING

Background: Upper gastrointestinal (UGI) bleeding is the leading cause for many hospital admissions which imposes a heavy expense on health care systems in most countries. The aim of this study was to compare the outcomes of therapeutic and diagnostic endoscopy in patients with upper GI bleeding. Materials and Methods: This retrospective study was carried out in a 2-year period (2002-4) on 145 patients undergone UGI endoscopy with a history of upper GI peptic ulcers in their diagnostic or therapetutic endoscopy reports hospitalized in Beheshti hospital. Participants were divided into two groups: endoscopically treated group (receiving managements such as diluted epinephrine injection or sclerosant material), and diagnostic endoscopy group. Results: Therapeutic endoscopy was done on 46 (31.7%) cases. Mean days of hospital stay was 7.23±2.64 and 8.97±3.73 in therapeutic and diagnostic endoscopy groups, respectively (P=0.005). Mean enquired unit of transfusion solution for therapeutic and endoscopic diagnostic groups was 6.54±3.30 and 9.05±3.9 respectively (P<0.001). Mortality rate due to upper GI bleeding in therapeutic and diagnostic endoscopy group was 2.3% and 8.3%, respectively (P=0.17). The need to surgical intervention in therapeutic and diagnostic endoscopy group was 6.5% and 19.1%, respectively (OR=4/3, P=0.048). Conclusion: Therapeutic endoscopy compared to medical treatment is an effective attempt to stop hemorrhage, establish homodynamic stability and prevent complications (e.g., early recurrent bleeding). In addition, using this approach has some advantages such as reduced transfusion rate and hospital stay and no need to surgical intervention. Hence it is recommended that therapeutic endoscopy be done for all patients with upper GI bleeding.