2021 Volume 98 Issue 1 Pages 29-33
Background: Endoscopic hemostasis for hemorrhagic duodenal ulcer (HDU) is useful, however, some cases still have been difficult due to rebleeding.
Aim: We investigated treatment outcomes of HDU patients and supposed the optimal management.
Methods: Sixty-five patients underwent endoscopic hemostasis for HDU were involved between January 2012 and February 2020. We retrospectively analyzed the risk factors for rebleeding and the usefulness of Glasgow-Blatchford Score (GBS) and AIMS65.
Results: In the refractory group, active bleeding (Forrest classification: Ia or Ib) (82% vs 38%, p<0.001), the proportion of hemodialysis (55 vs 7%, p<0.001), ischemic heart disease (63 vs 18%, p=0.005) and antithrombotic agent (55 vs 28%) were significant. The GBS and AIMS65 score of the refractory group were significantly higher (15.1/11.1, p=0.03), (2.27/1.66, p=0.03). Delayed perforation due to excessive forceps coagulation only occurred in two patients in the refractory group.
Conclusion: In patients with HDU who had high score by the GBS and AIMS65, we should consider surgical treatment and alternative treatment, such as polyglycolic acid shielding and the over-the-scope clip system at an early stage.
