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Multipolar (BICAP) endoscopic coagulation in hard bleeders from upper gastro intestinal tract ulceration: A prospective study

par Deltenre, Michel Arthur ;De Reuck, Marc ;Burette, Alain;Van Gossum, Marc ;Jonas, Claude ;Nyst, Jean-François ;Lemper, Jean-Claude
Référence Acta endoscopica, 18, 4, page (291-299)
Publication Publié, 1988

Article révisé par les pairs

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Résumé :

In order to assess the efficiency of endoscopic multipolar electrocoagulation (BICAP), a prospective study was undertaken in 1981 in a selected population of hard bleeders from various lesions of the upper gastro intestinal tract. Until May 1988, 137 patients (13.9% of 985 acute upper GI investigated by our group) have been included according strict condition(s): arterial spurting at emergency endoscopy, rebleeding during hospital stay, admission hematocrit below 25%, prothrombin time below 50 or grade 3-4 shock. The frequency of usual high risk factors was: renal failure and coagulation disorders in 15% of patients, onset of the haemorrhage in this hospital in 28% and respiratory distress in 24%. BICAP therapy alone allows permanent hemostasis in 94% of acute GD ulcers (n = 32) and in 77% of chronic GD ulcers (n = 82). Success rate was significantly lower in patients with severe lung disease or chronic duodenal ulcer (mainly lying on posterior wall) but did not depend on the hemodynamic status nor the presence of pumping artery or visible vessel. No complication was observed and since portability and low cost are additional advantages, BICAP coagulation must be recommended for an efficient and rapid management of hard bleeders from upper GI tract ulcer.