Abstract
From April 1988 to September 1994, endoscopic hemostatic therapies by microwave tissue coagulation were performed in 44 patients with bleeding gastric ulcers. The patients were observed again by endoscopic examinations within 24 hours after the first therapy to evaluate the endoscopic stigmata of recent hemorrhage. Initial hemostasis was obtained in all patients. Rebleeding occurred in eight patients. In six of the eight patients, second hemostasis succeeded by microwave coagulation. Permanent hemostasis was obtained in 42 patients. In all of four patients with spurting bleeding, hemostasis was achieved without rebleeding. Microwave therapy had good hemostatic effect in patients with underlying diseases. We studied the risk factors of rebleeding after microwave hemostasis. In patients without underlying disease, rebleeding was significantly associated with endo-scopic stigmata of recent hemorrhage. However, in patients with underlying diseases, rebleeding was significantly associated with prolongation of prothrombin time. It is important to evaluate these risk factors precisely to prevent rebleeding after endoscopic therapy.
