Therapeutic advances in gastroenterology · 2025
Efficacy and safety of endoscopic glue injection in acute peptic ulcer bleeding.
СтатьяНазвание и аннотация: Перевод в очереди
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Qi XingSi, Jia Li, Wang ShiDong, Zhang JunBo, Chen Hao, Xie Jing, Xu YuShuang
Аннотация
BACKGROUND: Optimal management of peptic ulcer bleeding remains a clinical challenge.
OBJECTIVES: To evaluate the efficacy and safety of endoscopic glue injection (EGI) for acute peptic ulcer bleeding.
DESIGN: Single-center retrospective study.
METHODS: This study (October 2015-December 2024) included adults (⩾18 years) with high-risk peptic ulcer bleeding (Forrest Ia-IIa) treated with EGI using n-butyl α-cyanoacrylate ester or standard endoscopic treatment (SET) involving contact thermal therapy and hemoclips. The primary endpoint was the rebleeding within 7 days, and the secondary endpoints included rebleeding within 30 days, 30-day all-cause mortality rate, occurrence of adverse events (AEs), and length of hospital stay and intensive care unit (ICU) stay. Risk factors for rebleeding within 7 days were also analyzed.
RESULTS: A total of 148 patients were included (EGI: 57; SET: 91). The rates of rebleeding within 7 days were 8.77% (EGI) versus 20.88% (SET; p = 0.067), and within 30 days were 8.77% versus 21.98%, respectively (p = 0.043). The 30-day all-cause mortality rate was 0.0% for EGI versus 1.1% for SET (p = 1.000). AEs-including Mallory-Weiss syndrome, esophageal blood blister, pulmonary embolism, hemorrhagic shock, cardiovascular or cerebrovascular events, infections, multiple organ failure, and lower limb thrombosis-did not differ significantly between groups (all p > 0.05). Mean hospital stay was shorter in the EGI group (10.91 ± 12.40 vs 15.38 ± 10.91 days; p = 0.002); ICU stay was similar (p = 0.153). Forrest classification Ia (odds ratio (OR) = 8.294; p = 0.013) and kidney disease (OR = 24.257; p = 0.003) were independent risk factors for rebleeding within 7 days.
CONCLUSION: EGI may be an effective and safe treatment for acute peptic ulcer bleeding, significantly reducing 30-day rebleeding and shortening hospital stay compared with SET. Clinicians should exercise heightened vigilance and consider more intensive monitoring or preventive strategies for patients with Forrest classification Ia ulcers or underlying kidney disease, who are at increased risk of early rebleeding.
OBJECTIVES: To evaluate the efficacy and safety of endoscopic glue injection (EGI) for acute peptic ulcer bleeding.
DESIGN: Single-center retrospective study.
METHODS: This study (October 2015-December 2024) included adults (⩾18 years) with high-risk peptic ulcer bleeding (Forrest Ia-IIa) treated with EGI using n-butyl α-cyanoacrylate ester or standard endoscopic treatment (SET) involving contact thermal therapy and hemoclips. The primary endpoint was the rebleeding within 7 days, and the secondary endpoints included rebleeding within 30 days, 30-day all-cause mortality rate, occurrence of adverse events (AEs), and length of hospital stay and intensive care unit (ICU) stay. Risk factors for rebleeding within 7 days were also analyzed.
RESULTS: A total of 148 patients were included (EGI: 57; SET: 91). The rates of rebleeding within 7 days were 8.77% (EGI) versus 20.88% (SET; p = 0.067), and within 30 days were 8.77% versus 21.98%, respectively (p = 0.043). The 30-day all-cause mortality rate was 0.0% for EGI versus 1.1% for SET (p = 1.000). AEs-including Mallory-Weiss syndrome, esophageal blood blister, pulmonary embolism, hemorrhagic shock, cardiovascular or cerebrovascular events, infections, multiple organ failure, and lower limb thrombosis-did not differ significantly between groups (all p > 0.05). Mean hospital stay was shorter in the EGI group (10.91 ± 12.40 vs 15.38 ± 10.91 days; p = 0.002); ICU stay was similar (p = 0.153). Forrest classification Ia (odds ratio (OR) = 8.294; p = 0.013) and kidney disease (OR = 24.257; p = 0.003) were independent risk factors for rebleeding within 7 days.
CONCLUSION: EGI may be an effective and safe treatment for acute peptic ulcer bleeding, significantly reducing 30-day rebleeding and shortening hospital stay compared with SET. Clinicians should exercise heightened vigilance and consider more intensive monitoring or preventive strategies for patients with Forrest classification Ia ulcers or underlying kidney disease, who are at increased risk of early rebleeding.