Monopolar Forceps with Soft Coagulation Effectively Treats Bleeding Peptic Ulcers

Monopolar forceps with soft coagulation was more effective in achieving initial hemostasis and resulted in less rebleeding compared with hemoclips.

The standard endoscopic treatment of high-risk peptic ulcers is epinephrine injection followed by bipolar cautery or hemoclips. Despite the popularity of hemoclips, initial bleeding control is not achieved in 5% to 20% of patients, and rebleeding occurs in 10% to 20%. A possible alternative is monopolar hemostatic forceps with soft coagulation (MHFSC), a technique widely used to control bleeding in patients undergoing endoscopic submucosal dissection (ESD), which has recently been applied to treating bleeding peptic ulcers.

MHFSC was compared with hemoclips for efficacy of achieving initial hemostasis in a randomized trial involving 112 patients with peptic ulcers and high-risk stigmata of recent hemorrhage (Forrest class 1a, 1b, or 2a). All…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute