Endoscopic Electrocoagulation in the Treatment of Upper Gastrointestinal Bleeding

摘要

Endoscopic electrocoagulation for the treatment of upper gastrointestinal (UGI) bleeding involves the application of an electric current to a bleeding lesion via an electrode passed into the gut through a channel of a flexible fiberoptic endoscope. It is difficult to arrive at definitive conclusions on this topic because approximately 80 percent of patients with upper gastrointestinal hemorrhage cease bleeding spontaneously and because the various techniques are probably operator dependent. Based on available information, however, it appears that in general, monopolar and bipolar-multipolar electrocoagulation have been utilized effectively in the therapy of bleeding peptic ulcers. Histologically, monopolar appears to cause more damage than bipolar-multipolar electrocoagulation, but has been suggested to have a somewhat lower incidence of rebleeding. The heater probe is a promising device for the endoscopic therapy of UGI bleeding, but the reported clinical experience to date is limited.