Long-term results of heater probe thermocoagulation for patients with massive peptic ulcer bleeding: a prospective observation.

OBJECTIVE

The long-term rebleeding rate of a bleeding ulcer after endoscopic hemostasis is, so far, not clear. The goal of this study is to present the natural history of bleeding ulcers after heater probe thermocoagulation.

METHODS

Between September 1986 and June 1991, we used heater probe to treat 202 patients with active bleeding or nonbleeding visible vessels at the ulcer craters. We were able to follow 159 patients for 2-7 yr (mean +/- SD: 54.5 +/- 19.9 months). Patients with active bleeding or nonbleeding visible vessels who did not receive endoscopic hemostasis or surgery in our previous studies served as controls.

RESULTS

The energy applied to each patient in the heater probe group was 886 +/- 844 J (mean +/- SD). The ultimate hemostatic rate in the heater probe group was 91.2% (145/159). In the period of long-term follow-up, there were 32 episodes of rebleeding in 24 patients (16.6%). Most rebleeding episodes (22/32) subsided spontaneously. Only one rebleeding patient died before a surgical attempt. The rebleeding rate was less than that of the controls (43/87, p < 0.0001).

CONCLUSION

Heater probe thermocoagulation is very effective in arrest of peptic ulcer bleeding. In the long-term follow-up, heater probe thermocoagulation can decrease rebleeding rate in most patients with peptic ulcer hemorrhage.