No Benefit of Second-Look Endoscopy After Endoscopic Hemostasis

Endoscopic therapy for bleeding peptic ulcers with high-risk stigmata improves clinical outcomes. Studies evaluating the benefit of a scheduled second-look endoscopy have shown mixed results. To further investigate this issue, researchers from seven hospitals in Korea randomized 319 patients with high-risk stigmata treated endoscopically to undergo routine therapy or a scheduled second-look endoscopy after 24 to 36 hours. All patients received twice-daily, high-dose intravenous proton-pump inhibitor therapy. Results were as follows:

• Rebleeding rates were not significantly different between second-look endoscopy recipients and controls at 7 days (9% and 5%, respectively) nor at 30 days (10% and 6%).

• Endoscopic retreatment failed in three patie…