Oral 6 – Endoscopic vs Conservative Treatment for Bleeding Peptic Ulcer With Adherent Clot: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials
Monday, October 24, 2022 | 8:48 AM – 9:00 AM ET | Location: Hall C2
Author Insight from Azizullah Beran, MD, Indiana University, Division of Gastroenterology and Hepatology
What’s new here and important for clinicians?
The optimal management of bleeding peptic ulcers (PUDs) with adherent clots, including endoscopic or conservative therapy, remains controversial. In this comprehensive meta-analysis of RCTs, we found that endoscopic therapy is superior to conservative treatment for bleeding PUDs with an adherent clot in terms of rebleeding, need for surgery, and length of hospital stay. However, there was no significant difference in mortality between the two groups. Based on our study findings, gastroenterologists should consider endoscopic therapy for patients with an adherent clot to reduce the risk of rebleeding, surgery, and hospital length of stay.
What do patients need to know?
Peptic ulcers can present with different classifications. One of these classifications is an ulcer with an adherent clot, which carries an 8% to 36% risk of recurrent bleeding. However, the optimal treatment of bleeding PUD with adherent clots, whether to perform an endoscopic intervention or treat it with medical therapy, remains unclear. Our study found that patients who underwent endoscopic interventions in addition to medical treatment had lower rates of recurrent bleeding, need for surgery, and shorter hospital length-of-stay compared to those treated medically only. However, the death rate was comparable between the two groups.
Read the Abstract
Azizullah Beran, MD, Indiana University, Division of Gastroenterology and Hepatology
aziz [at] iu.edu
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