In a period of 2 years 7 months, we performed heat probe (HP)
thermocoagulation in 153 cases of massive
peptic ulcer hemorrhage. The male/female sex ratio was 125/28. The average age was 57.6 +/- 1.3 years (mean +/- SEM; range, 17 to 88). There were 69 cases (45.1%) of spurting
hemorrhage, 50 cases (32.7%) of oozing
hemorrhage, and 34 cases (22.2%) of nonbleeding visible vessels. Seventy-seven patients (50.3%) were in
shock before
therapy. After
therapy we obtained initial success in 147 cases (96.1%). Rebleeding episodes occurred in 23 patients (15.6%) within 1 month after
therapy. Nineteen patients received a second
therapy, and treatment in 15 of these cases (78.9%) was ultimately successful. Finally, treatment in 142 cases (92.8%) was ultimately successful. The duration of hospitalization was 6.3 +/- 0.4 days (mean +/- SEM). After discharge all patients were followed at the outpatient department for at least 1 month. Sixty-seven patients were followed endoscopically for at least 2 to 3 months after
therapy. Fifty-six patients (83.6%) had a healed
scar at the previous
bleeding site 2 months after
therapy, and 62 patients (92.5%) had a healed
scar 3 months after
therapy. We conclude that HP
thermocoagulation is an ideal and reliable modality of therapeutic endoscopy in arrest of massive
peptic ulcer hemorrhage. HP
thermocoagulation may become the first choice of
therapy for massive
peptic ulcer bleeding in the near future.