Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2021; 12(02): 078-092
DOI: 10.1055/s-0041-1731962
Review Article

Endotherapy for Nonvariceal Upper Gastrointestinal Hemorrhage

Chhagan L. Birda
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Antriksh Kumar
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Jayanta Samanta
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations Funding None
› Further Information
Also available at
   Permissions and Reprints

Abstract

Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is a common GI emergency with significant morbidity and mortality. Triaging cases on the basis of patient-related factors, restrictive blood transfusion strategy, and hemodynamic stabilization are key initial steps for the management of patients with NVUGIH. Endoscopy remains a vital step for both diagnosis and definitive management. Multiple studies and guidelines have now defined the optimum timing for performing the endoscopy after hospitalization, to better the outcome. Conventional methods for achieving endoscopic hemostasis, such as injection therapy, contact, and noncontact thermal therapy, and mechanical therapy, such as through-the-scope clips, have reported to have 76 to 90% efficacy for primary hemostasis. Newer modalities to enhance hemostasis rates have come in vogue. Many of these modalities, such as cap-mounted clips, coagulation forceps, and hemostatic powders have proved to be efficacious in multiple studies. Thus, the newer modalities are recommended not only for management of persistent bleed and recurrent bleed after failed initial hemostasis, using conventional modalities but also now being advocated for primary hemostasis. Failure of endotherapy would warrant radiological or surgical intervention. Some newer tools to optimize endotherapy, such as endoscopic Doppler probes, for determining flow in visible or underlying vessels in ulcer bleed are now being evaluated. This review is focused on the technical aspects and efficacy of various endoscopic modalities, both conventional and new. A synopsis of the various studies describing and comparing the modalities have been outlined. Postendoscopic management including Helicobacter pylori therapy and starting of anticoagulants and antiplatelets have also been outlined.

Keywords

upper gastrointestinal bleed - heat probe - endoscopic hemostasis - Helicobacter pylori - proton pump inhibitors

Supplementary Material



Publication History

Article published online:
30 July 2021

© 2021. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ 2019; 364: l536
    CrossrefPubMedSearch in Google Scholar
  • 2 Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000; 356 (9238) 1318-1321
    CrossrefPubMedSearch in Google Scholar
  • 3 Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996; 38 (03) 316-321
    CrossrefPubMedSearch in Google Scholar
  • 4 Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc 2011; 74 (06) 1215-1224
    CrossrefPubMedSearch in Google Scholar
  • 5 Baradarian R, Ramdhaney S, Chapalamadugu R. et al. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality. Am J Gastroenterol 2004; 99 (04) 619-622
    CrossrefPubMedSearch in Google Scholar
  • 6 Binmoeller KF, Thonke F, Soehendra N. Endoscopic hemoclip treatment for gastrointestinal bleeding. Endoscopy 1993; 25 (02) 167-170
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Naseer M, Lambert K, Hamed A, Ali E. Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding: A review. World J Gastrointest Endosc 2020; 12 (01) 1-16
    CrossrefPubMedSearch in Google Scholar
  • 8 Banerjee A, Bishnu S, Dhali GK. Acute upper gastrointestinal bleed: An audit of the causes and outcomes from a tertiary care center in eastern India. Indian J Gastroenterol 2019; 38 (03) 190-202
    CrossrefPubMedSearch in Google Scholar
  • 9 Mathew P, Kanni PY, Gowda M. et al. Retrospective study of clinical profile, endoscopic profile and in hospital mortality in acute upper gastrointestinal bleeding in tertiary care centre in South India. International Journal of Contemporary Medical Research 2019; 6 (08) H1-H5
    Search in Google Scholar
  • 10 Sourabh S, Sharma N, Sharma R. et al. Clinical profile, severity and outcome of acute upper gastrointestinal bleeding in elderly patients compared to non-elderly patients: a prospective observational study. J Assoc Physicians India 2019; 67 (09) 30-32
    PubMedSearch in Google Scholar
  • 11 Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc 2015; 81 (04) 882-8.e1
    CrossrefPubMedSearch in Google Scholar
  • 12 Taefi A, Cho WK, Nouraie M. Decreasing trend of upper gastrointestinal bleeding mortality risk over three decades. Dig Dis Sci 2013; 58 (10) 2940-2948
    CrossrefPubMedSearch in Google Scholar
  • 13 Laine L, Yang H, Chang SC, Datto C. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am J Gastroenterol 2012; 107 (08) 1190-1195
    CrossrefPubMedSearch in Google Scholar
  • 14 Wuerth BA, Rockey DC. Changing epidemiology of upper gastrointestinal hemorrhage in the last decade: a nationwide analysis. Dig Dis Sci 2018; 63 (05) 1286-1293
    CrossrefPubMedSearch in Google Scholar
  • 15 Loperfido S, Baldo V, Piovesana E. et al. Changing trends in acute upper-GI bleeding: a population-based study. Gastrointest Endosc 2009; 70 (02) 212-224
    CrossrefPubMedSearch in Google Scholar
  • 16 Ramaekers R, Mukarram M, Smith CA, Thiruganasambandamoorthy V. The predictive value of preendoscopic risk scores to predict adverse outcomes in emergency department patients with upper gastrointestinal bleeding: a systematic review. Acad Emerg Med 2016; 23 (11) 1218-1227
    CrossrefPubMedSearch in Google Scholar
  • 17 Stanley AJ, Laine L, Dalton HR. et al. International Gastrointestinal Bleeding Consortium. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ 2017; 356: i6432
    CrossrefPubMedSearch in Google Scholar
  • 18 Villanueva C, Colomo A, Bosch A. et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013; 368 (01) 11-21
    CrossrefPubMedSearch in Google Scholar
  • 19 Derogar M, Sandblom G, Lundell L. et al. Discontinuation of low-dose aspirin therapy after peptic ulcer bleeding increases risk of death and acute cardiovascular events. Clin Gastroenterol Hepatol 2013; 11 (01) 38-42
    CrossrefPubMedSearch in Google Scholar
  • 20 Wang XX, Dong B, Hong B. et al. Long-term prognosis in patients continuing taking antithrombotics after peptic ulcer bleeding. World J Gastroenterol 2017; 23 (04) 723-729
    CrossrefPubMedSearch in Google Scholar
  • 21 Barkun AN, Almadi M, Kuipers EJ. et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med 2019; 171 (11) 805-822
    CrossrefPubMedSearch in Google Scholar
  • 22 Fujishiro M, Iguchi M, Kakushima N. et al. Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding. Dig Endosc 2016; 28 (04) 363-378
    CrossrefPubMedSearch in Google Scholar
  • 23 Mujtaba S, Chawla S, Massaad JF. Diagnosis and management of non-variceal gastrointestinal hemorrhage: a review of current guidelines and future perspectives. J Clin Med 2020; 9 (02) 402
    CrossrefPubMedSearch in Google Scholar
  • 24 Karstensen JG, Ebigbo A, Aabakken L. et al. Nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) cascade guideline. Endosc Int Open 2018; 6 (10) E1256-E1263
    Thieme ConnectPubMedSearch in Google Scholar
  • 25 Gralnek IM, Stanley AJ, Morris AJ. et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2021. Endoscopy 2021; 53 (03) 300-332
    Thieme ConnectPubMedSearch in Google Scholar
  • 26 Mullady DK, Wang AY, Waschke KA. AGA clinical practice update on endoscopic therapies for non-variceal upper gastrointestinal bleeding: expert review. Gastroenterology 2020; 159 (03) 1120-1128
    CrossrefPubMedSearch in Google Scholar
  • 27 Sostres C, Marcén B, Laredo V. et al. Risk of rebleeding, vascular events and death after gastrointestinal bleeding in anticoagulant and/or antiplatelet users. Aliment Pharmacol Ther 2019; 50 (08) 919-929
    CrossrefPubMedSearch in Google Scholar
  • 28 Sreedharan A, Martin J, Leontiadis GI. et al. Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database Syst Rev 2010; 20102010 (07) CD00-5415
    Search in Google Scholar
  • 29 Sung JJ, Chiu PW, Chan FKL. et al. Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018. Gut 2018; 67 (10) 1757-1768
    CrossrefPubMedSearch in Google Scholar
  • 30 Riha HM, Wilkinson R, Twilla J. et al. Octreotide added to a proton pump inhibitor versus a proton pump inhibitor alone in nonvariceal upper-gastrointestinal bleeds. Ann Pharmacother 2019; 53 (08) 794-800
    CrossrefPubMedSearch in Google Scholar
  • 31 HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet 2020; 395 (10241) 1927-1936
    CrossrefPubMedSearch in Google Scholar
  • 32 Bai Y, Guo JF, Li ZS. Meta-analysis: erythromycin before endoscopy for acute upper gastrointestinal bleeding. Aliment Pharmacol Ther 2011; 34 (02) 166-171
    CrossrefPubMedSearch in Google Scholar
  • 33 Kessel B, Olsha O, Younis A, Daskal Y, Granovsky E, Alfici R. Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena. Eur J Emerg Med 2016; 23 (01) 71-73
    CrossrefPubMedSearch in Google Scholar
  • 34 Chaudhuri D, Bishay K, Tandon P. et al. Prophylactic endotracheal intubation in critically ill patients with upper gastrointestinal bleed: a systematic review and meta-analysis. JGH Open 2019; 4 (01) 22-28
    CrossrefPubMedSearch in Google Scholar
  • 35 Lau JYW, Yu Y, Tang RSY. et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med 2020; 382 (14) 1299-1308
    CrossrefPubMedSearch in Google Scholar
  • 36 Garg SK, Anugwom C, Campbell J. et al. Early esophagogastroduodenoscopy is associated with better outcomes in upper gastrointestinal bleeding: a nationwide study. Endosc Int Open 2017; 5 (05) E376-E386
    Thieme ConnectPubMedSearch in Google Scholar
  • 37 Siau K, Hodson J, Ingram R. et al. Time to endoscopy for acute upper gastrointestinal bleeding: Results from a prospective multicentre trainee-led audit. United European Gastroenterol J 2019; 7 (02) 199-209
    CrossrefPubMedSearch in Google Scholar
  • 38 Jeong N, Kim KS, Jung YS, Kim T, Shin SM. Delayed endoscopy is associated with increased mortality in upper gastrointestinal hemorrhage. Am J Emerg Med 2019; 37 (02) 277-280
    CrossrefPubMedSearch in Google Scholar
  • 39 Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet 1974; 2 (7877) 394-397
    CrossrefPubMedSearch in Google Scholar
  • 40 Jensen DM, Eklund S, Persson T. et al. Reassessment of rebleeding risk of Forrest IB (Oozing) peptic ulcer bleeding in a large international randomized trial. Am J Gastroenterol 2017; 112 (03) 441-446
    CrossrefPubMedSearch in Google Scholar
  • 41 Elmunzer BJ, Young SD, Inadomi JM, Schoenfeld P, Laine L. Systematic review of the predictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers. Am J Gastroenterol 2008; 103 (10) 2625-2632
    CrossrefPubMedSearch in Google Scholar
  • 42 Sung JJ, Tsoi KK, Lai LH, Wu JC, Lau JY. Endoscopic clipping versus injection and thermo-coagulation in the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis. Gut 2007; 56 (10) 1364-1373
    CrossrefPubMedSearch in Google Scholar
  • 43 Marmo R, Rotondano G, Piscopo R, Bianco MA, D’Angella R, Cipolletta L. Dual therapy versus monotherapy in the endoscopic treatment of high-risk bleeding ulcers: a meta-analysis of controlled trials. Am J Gastroenterol 2007; 102 (02) 279-289
    CrossrefPubMedSearch in Google Scholar
  • 44 Calvet X, Vergara M, Brullet E, Gisbert JP, Campo R. Addition of a second endoscopic treatment following epinephrine injection improves outcome in high-risk bleeding ulcers. Gastroenterology 2004; 126 (02) 441-450
    CrossrefPubMedSearch in Google Scholar
  • 45 Vergara M, Bennett C, Calvet X, Gisbert JP. Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers. Cochrane Database Syst Rev 2014; (10) CD00-5584
    Search in Google Scholar
  • 46 Saltzman JR, Strate LL, Di Sena V. et al. Prospective trial of endoscopic clips versus combination therapy in upper GI bleeding (PROTECCT–UGI bleeding. Am J Gastroenterol 2005; 100 (07) 1503-1508
    CrossrefPubMedSearch in Google Scholar
  • 47 Lin HJ, Perng CL, Sun IC, Tseng GY. Endoscopic haemoclip versus heater probe thermocoagulation plus hypertonic saline-epinephrine injection for peptic ulcer bleeding. Dig Liver Dis 2003; 35 (12) 898-902
    CrossrefPubMedSearch in Google Scholar
  • 48 Parsi MA, Schulman AR, Aslanian HR. et al. ASGE technology committee; ASGE Technology Committee Chair. Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos. VideoGIE 2019; 4 (07) 285-299
    CrossrefPubMedSearch in Google Scholar
  • 49 Wang TJ, Aihara H, Thompson AC, Schulman AR, Thompson CC, Ryou M. Choosing the right through-the-scope clip: a rigorous comparison of rotatability, whip, open/close precision, and closure strength (with videos. Gastrointest Endosc 2019; 89 (01) 77-86.e1
    CrossrefPubMedSearch in Google Scholar
  • 50 Cipolletta L, Bianco MA, Marmo R. et al. Endoclips versus heater probe in preventing early recurrent bleeding from peptic ulcer: a prospective and randomized trial. Gastrointest Endosc 2001; 53 (02) 147-151
    CrossrefPubMedSearch in Google Scholar
  • 51 Lin HJ, Hsieh YH, Tseng GY, Perng CL, Chang FY, Lee SD. A prospective, randomized trial of endoscopic hemoclip versus heater probe thermocoagulation for peptic ulcer bleeding. Am J Gastroenterol 2002; 97 (09) 2250-2254
    CrossrefPubMedSearch in Google Scholar
  • 52 Peng YC, Chen SW, Tung CF, Chow WK, Ho SP, Chang CS. Comparison the efficacy of intermediate dose argon plasma coagulation versus hemoclip for upper gastrointestinal non-variceal bleeding. Hepatogastroenterology 2013; 60 (128) 2004-2010
    PubMedSearch in Google Scholar
  • 53 García-Iglesias P, Villoria A, Suarez D. et al. Meta-analysis: predictors of rebleeding after endoscopic treatment for bleeding peptic ulcer. Aliment Pharmacol Ther 2011; 34 (08) 888-900
    CrossrefPubMedSearch in Google Scholar
  • 54 Kim JW, Jang JY, Lee CK, Shim JJ, Chang YW. Comparison of hemostatic forceps with soft coagulation versus argon plasma coagulation for bleeding peptic ulcer–a randomized trial. Endoscopy 2015; 47 (08) 680-687
    Thieme ConnectPubMedSearch in Google Scholar
  • 55 Nunoue T, Takenaka R, Hori K. et al. A randomized trial of monopolar soft-mode coagulation versus heater probe thermocoagulation for peptic ulcer bleeding. J Clin Gastroenterol 2015; 49 (06) 472-476
    CrossrefPubMedSearch in Google Scholar
  • 56 Arima S, Sakata Y, Ogata S. et al. Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial. J Gastroenterol 2010; 45 (05) 501-505
    CrossrefPubMedSearch in Google Scholar
  • 57 Kataoka M, Kawai T, Hayama Y. et al. Comparison of hemostasis using bipolar hemostatic forceps with hemostasis by endoscopic hemoclipping for nonvariceal upper gastrointestinal bleeding in a prospective non-randomized trial. Surg Endosc 2013; 27 (08) 3035-3038
    CrossrefPubMedSearch in Google Scholar
  • 58 Richter-Schrag HJ, Glatz T, Walker C, Fischer A, Thimme R. First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases. World J Gastroenterol 2016; 22 (41) 9162-9171
    CrossrefPubMedSearch in Google Scholar
  • 59 Wedi E, Fischer A, Hochberger J, Jung C, Orkut S, Richter-Schrag HJ. Multicenter evaluation of first-line endoscopic treatment with the OTSC in acute non-variceal upper gastrointestinal bleeding and comparison with the Rockall cohort: the FLETRock study. Surg Endosc 2018; 32 (01) 307-314
    CrossrefPubMedSearch in Google Scholar
  • 60 Chandrasekar VT, Desai M, Aziz M. et al. Efficacy and safety of over-the-scope clips for gastrointestinal bleeding: a systematic review and meta-analysis. Endoscopy 2019; 51 (10) 941-949
    Thieme ConnectPubMedSearch in Google Scholar
  • 61 Gölder S, Neuhas L, Freuer D. et al. Over-the-scope clip in peptic ulcer bleeding: clinical success in primary and secondary treatment and factors associated with treatment failure. Endosc Int Open 2019; 7 (06) E846-E854
    Thieme ConnectPubMedSearch in Google Scholar
  • 62 Jensen DM, Kovacs T, Ghassemi KA, Kaneshiro M, Gornbein J. Randomized controlled trial of over-the-scope clip as initial treatment of severe nonvariceal upper gastrointestinal bleeding. Clin Gastroenterol Hepatol 2020;
    CrossrefPubMedSearch in Google Scholar
  • 63 Schmidt A, Gölder S, Goetz M. et al. Over-the-scope clips are more effective than standard endoscopic therapy for patients with recurrent bleeding of peptic ulcers. Gastroenterology 2018; 155 (03) 674-686.e6
    CrossrefPubMedSearch in Google Scholar
  • 64 Brandler J, Baruah A, Zeb M. et al. Efficacy of over-the-scope clips in management of high-risk gastrointestinal bleeding. Clin Gastroenterol Hepatol 2018; 16 (05) 690-696.e1
    CrossrefPubMedSearch in Google Scholar
  • 65 Haddara S, Jacques J, Lecleire S. et al. A novel hemostatic powder for upper gastrointestinal bleeding: a multicenter study (the “GRAPHE” registry. Endoscopy 2016; 48 (12) 1084-1095
    Thieme ConnectPubMedSearch in Google Scholar
  • 66 Chen YI, Barkun A, Nolan S. Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution. Endoscopy 2015; 47 (02) 167-171
    PubMedSearch in Google Scholar
  • 67 Prei JC, Barmeyer C, Bürgel N. et al. EndoClot polysaccharide hemostatic system in nonvariceal gastrointestinal bleeding: results of a prospective multicenter observational pilot study. J Clin Gastroenterol 2016; 50 (10) e95-e100
    CrossrefPubMedSearch in Google Scholar
  • 68 Park JS, Kim HK, Shin YW, Kwon KS, Lee DH. Novel hemostatic adhesive powder for nonvariceal upper gastrointestinal bleeding. Endosc Int Open 2019; 7 (12) E1763-E1767
    Thieme ConnectPubMedSearch in Google Scholar
  • 69 Alzoubaidi D, Hussein M, Rusu R. et al. Outcomes from an international multicenter registry of patients with acute gastrointestinal bleeding undergoing endoscopic treatment with Hemospray. Dig Endosc 2020; 32 (01) 96-105
    CrossrefPubMedSearch in Google Scholar
  • 70 Baracat FI, de Moura DTH, Brunaldi VO. et al.  Randomized controlled trial of hemostatic powder versus endoscopic clipping for non-variceal upper gastrointestinal bleeding. Surg Endosc 2020; 34 (01) 317-324
    CrossrefPubMedSearch in Google Scholar
  • 71 Prasad VGM, Prasad M, Asif SM. et al. Endoscopic collagen spray– a novel method which can be used as an adjunct to conventional hemostatic techniques in peptic ulcer bleeding. J Clin Gastroenterol Hepatol 2018; 2 (01)
    CrossrefSearch in Google Scholar
  • 72 Agarwal A, Benias P, Brewer Gutierrez OI. et al. Endoscopic suturing for management of peptic ulcer-related upper gastrointestinal bleeding: a preliminary experience. Endosc Int Open 2018; 6 (12) E1439-E1444
    Thieme ConnectPubMedSearch in Google Scholar
  • 73 Barola S, Fayad L, Hill C. et al. Endoscopic management of recalcitrant marginal ulcers by covering the ulcer bed. Obes Surg 2018; 28 (08) 2252-2260
    CrossrefPubMedSearch in Google Scholar
  • 74 Levy MJ, Wong Kee Song LM, Farnell MB, Misra S, Sarr MG, Gostout CJ. Endoscopic ultrasound (EUS)-guided angiotherapy of refractory gastrointestinal bleeding. Am J Gastroenterol 2008; 103 (02) 352-359
    CrossrefPubMedSearch in Google Scholar
  • 75 García de la Filia I, Hernanz N, Vázquez Sequeiros E, Tavío Hernández E. Recurrent gastrointestinal bleeding secondary to Dieulafoy’s lesion successfully treated with endoscopic ultrasound-guided sclerosis. Gastroenterol Hepatol 2018; 41 (05) 319-320
    CrossrefPubMedSearch in Google Scholar
  • 76 Kantowski M, Schoepfer AM, Settmacher U, Stallmach A, Schmidt C. Assessment of endoscopic Doppler to guide hemostasis in high risk peptic ulcer bleeding. Scand J Gastroenterol 2018; 53 (10-11) 1311-1318
    CrossrefPubMedSearch in Google Scholar
  • 77 Jensen DM, Kovacs TOG, Ohning GV. et al. Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes of patients with severe nonvariceal upper gastrointestinal hemorrhage. Gastroenterology 2017; 152 (06) 1310-1318.e1
    CrossrefPubMedSearch in Google Scholar
  • 78 Sverdén E, Mattsson F, Lindström D, Sondén A, Lu Y, Lagergren J. Transcatheter arterial embolization compared with surgery for uncontrolled peptic ulcer bleeding: a population-based cohort study. Ann Surg 2019; 269 (02) 304-309
    CrossrefPubMedSearch in Google Scholar
  • 79 Kyaw M, Tse Y, Ang D, Ang TL, Lau J. Embolization versus surgery for peptic ulcer bleeding after failed endoscopic hemostasis: a meta-analysis. Endosc Int Open 2014; 2 (01) E6-E14
    Thieme ConnectPubMedSearch in Google Scholar
  • 80 Lau JY, Sung JJ, Lam YH. et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999; 340 (10) 751-756
    CrossrefPubMedSearch in Google Scholar
  • 81 Grassia R, Capone P, Iiritano E. et al. Non-variceal upper gastrointestinal bleeding: rescue treatment with a modified cyanoacrylate. World J Gastroenterol 2016; 22 (48) 10609-10616
    CrossrefPubMedSearch in Google Scholar
  • 82 Park SJ, Park H, Lee YC. et al. Effect of scheduled second-look endoscopy on peptic ulcer bleeding: a prospective randomized multicenter trial. Gastrointest Endosc 2018; 87 (02) 457-465
    CrossrefPubMedSearch in Google Scholar
  • 83 Lau JYW, Pittayanon R, Wong KT. et al. Prophylactic angiographic embolisation after endoscopic control of bleeding to high-risk peptic ulcers: a randomised controlled trial. Gut 2019; 68 (05) 796-803
    CrossrefPubMedSearch in Google Scholar
  • 84 Jensen DM, Ohning GV, Kovacs TO. et al. Doppler endoscopic probe as a guide to risk stratification and definitive hemostasis of peptic ulcer bleeding. Gastrointest Endosc 2016; 83 (01) 129-136
    CrossrefPubMedSearch in Google Scholar
  • 85 Sachar H, Vaidya K, Laine L. Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis. JAMA Intern Med 2014; 174 (11) 1755-1762
    CrossrefPubMedSearch in Google Scholar
  • 86 Gisbert JP, Khorrami S, Carballo F, Calvet X, Gene E, Dominguez-Muñoz E. Meta-analysis: Helicobacter pylori eradication therapy vs. antisecretory non-eradication therapy for the prevention of recurrent bleeding from peptic ulcer. Aliment Pharmacol Ther 2004; 19 (06) 617-629
    CrossrefPubMedSearch in Google Scholar
  • 87 Gisbert JP, Abraira V. Accuracy of Helicobacter pylori diagnostic tests in patients with bleeding peptic ulcer: a systematic review and meta-analysis. Am J Gastroenterol 2006; 101 (04) 848-863
    CrossrefPubMedSearch in Google Scholar
  • 88 Kido K, Scalese MJ. Management of oral anticoagulation therapy after gastrointestinal bleeding: whether to, when to, and how to restart an anticoagulation therapy. Ann Pharmacother 2017; 51 (11) 1000-1007
    CrossrefPubMedSearch in Google Scholar
  • 89 Moayyedi P, Eikelboom JW, Bosch J. et al. COMPASS Investigators. Pantoprazole to prevent gastroduodenal events in patients receiving rivaroxaban and/or aspirin in a randomized, double-blind, placebo-controlled trial. Gastroenterology 2019; 157 (02) 403-412.e5
    CrossrefPubMedSearch in Google Scholar
  • 90 Rajan SS, Sawe HR, Iyullu AJ. et al. Profile and outcome of patients with upper gastrointestinal bleeding presenting to urban emergency departments of tertiary hospitals in Tanzania. BMC Gastroenterol 2019; 19 (01) 212
    CrossrefPubMedSearch in Google Scholar
  • 91 Alatise OI, Aderibigbe AS, Adisa AO, Adekanle O, Agbakwuru AE, Arigbabu AO. Management of overt upper gastrointestinal bleeding in a low resource setting: a real world report from Nigeria. BMC Gastroenterol 2014; 14: 210
    CrossrefPubMedSearch in Google Scholar
  • 92 Tsoi KK, Lau JY, Sung JJ. Cost-effectiveness analysis of high-dose omeprazole infusion before endoscopy for patients with upper-GI bleeding. Gastrointest Endosc 2008; 67 (07) 1056-1063
    CrossrefPubMedSearch in Google Scholar
  • 93 Kuellmer A, Behn J, Meier B. et al. Over-the-scope clips are cost-effective in recurrent peptic ulcer bleeding. United European Gastroenterol J 2019; 7 (09) 1226-1233
    CrossrefPubMedSearch in Google Scholar