Second-Look Endoscopy vs. High-Dose PPI for Bleeding Peptic Ulcers

Although some data suggest that routine second-look endoscopy (SLE) can reduce rebleeding after endoscopic therapy for peptic ulcer bleeding (PUB), most are from studies that were conducted prior to the routine use of proton-pump inhibitor (PPI) infusions.

To compare the efficacy of SLE and PPI infusion in preventing rebleeding after endoscopic therapy for PUB, investigators in Hong Kong randomized 305 consecutive patients post-hemostasis to receive either high-dose intravenous PPI for 72 hours or a PPI bolus every 12 hours for 72 hours and a scheduled SLE 16–24 hours after the initial endoscopy.

Thirty-day rebleeding was similar between the two groups (7% for PPI infusion and 8% for SLE). Only 10.5% of patients required additional endoscopic…