Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study.

@article{Lin1996EarlyOD,
  title={Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study.},
  author={H. J. Lin and K. Wang and C. Perng and R. Chua and F. Lee and C. Lee and S. Lee},
  journal={Journal of clinical gastroenterology},
  year={1996},
  volume={22 4},
  pages={
          267-71
        }
}
The benefit of early endoscopy in the management of peptic ulcer bleeding remains controversial. In this study we looked at the role of early endoscopy in bleeding peptic ulcer patients with clear, "coffee grounds," or bloody nasogastric aspirate. A consecutive series of 325 patients with peptic ulcer bleeding were included (218 patients with clear aspirate, 77 patients with coffee-grounds aspirate, and 30 patients with bloody aspirate). They were randomized to receive early endoscopy (within… Expand
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Relationship between timing of endoscopy and mortality in patients with peptic ulcer bleeding: a nationwide cohort study.
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Introduction: Although upper gastrointestinal bleeding (UGIB) management has improved substantially in the last decades, there is still much controversy regarding the optimal timing for performanceExpand
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References

SHOWING 1-10 OF 22 REFERENCES
Routine early endoscopy in upper-gastrointestinal-tract bleeding: a randomized, controlled trial.
TLDR
It is concluded that endoscopy should not be a routine procedure in patients with upper-gastrointestinal-tract bleeding that ceases during treatment. Expand
Characteristics of patients with bleeding peptic ulcer requiring emergency endoscopy and aggressive treatment.
TLDR
Clinical parameters that predict patients with bleeding peptic ulcer who have coffee ground fluid or blood from the nasogastric tube should receive an emergency endoscopy and aggressive treatment. Expand
Impact of endoscopic therapy on outcome of operation for bleeding peptic ulcers.
TLDR
Endoscopic control of UGI bleeding from peptic ulcer disease has decreased the incidence of operation compared with historical series; overall operative mortality is decreasing; and the major postoperative complication is rebleeding. Expand
Limited value of early endoscopy in the management of acute upper gastrointestinal bleeding. Prospective controlled trial.
  • D. Graham
  • Medicine
  • American journal of surgery
  • 1980
TLDR
It is concluded that the natural history of acute upper gastrointestinal hemorrhage (for example, the spontaneous cessation of bleeding) precludes endoscopy from having a significant effect on patient management. Expand
Outcome of endoscopy and barium radiography for acute upper gastrointestinal bleeding: controlled trial in 1037 patients.
TLDR
Endoscopy may be a more accurate means of diagnosis than radiography, but it offers no short-term benefits in management and postoperative mortality was higher in the endoscopy group. Expand
Bleeding pattern before admission as guideline for emergency endoscopy.
TLDR
Black hematemesis with melena was the superior predictor of bleeding ulcer, the commonest lesion carrying the risk of massive hemorrhage and the order of prognostic importance was supported by the transfusion requirement. Expand
Endoscopic hemostasis. An effective therapy for bleeding peptic ulcers.
TLDR
It is concluded that endoscopic hemostasis is clearly effective but that data were insufficient for direct comparisons between modalities, and Randomized control trials to compare the different modes of endoscopic therapy should continue. Expand
Endoscopic injection for the arrest of peptic ulcer hemorrhage: final results of a prospective, randomized comparative trial.
TLDR
It is suggested that endoscopic injection with any of the above solutions can be used as the first-line modality for the arrest of peptic ulcer hemorrhage. Expand
The benefits of endoscopy in upper gastrointestinal bleeding.
TLDR
Management of the patient with upper gastrointestinal bleeding is a continuing challenge to the gastroenterologist and the surgeon and effective methods are now available for endoscopic hemostasis of bleeding ulcers and bleeding varices. Expand
Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis.
TLDR
Examination of subgroups indicated that endoscopic treatment decreased rates of further bleeding, surgery, and mortality in patients with high-risk endoscopic features of active bleeding or nonbleeding visible vessels, including ulcers containing flat pigmented spots or adherent clots. Expand
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