Clips, Injection, or Thermal Therapy for Nonvariceal Upper Gastrointestinal Bleeding?

Endoscopic therapy reduces the risk for rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding (UGIB) who have high-risk lesions. Both thermal therapy and endoscopically placed hemostatic clips have demonstrated similar efficacy in this setting. Studies in which the two therapies have been compared with each other or with volume injection, however, have been small and have provided conflicting results.

Investigators performed a meta-analysis to compare rebleeding rates with various treatments in patients with UGIB. The investigators chose 15 studies in which 1156 patients were assigned to clips or another therapy (injection or thermal); in all studies, therapy was limited to endoscopically identified high-risk …