Clinical Changes in Emergency Endoscopic Hemostasis for Gastroduodenal Ulcer

Introduction: This study aimed to examine the endoscopic hemostasis methods and characteristics of patients with gastroduodenal ulcer by comparing two sets of 5-year data. Included in this study are patients who were treated with emergency upper gastrointestinal endoscopy in our hospital over a 10-year study period. Methods: Patients with hemorrhagic gastroduodenal ulcers who were treated with endoscopic hemostasis via emergency upper gastrointestinal endoscopy in our hospital from January 2004 to December 2008 and from January 2014 to December 2018 were categorized into Groups A and B, respectively. The two groups were retrospectively compared with regard to patient characteristics, hemostasis method, and various risk factors. Results: Endoscopic hemostasis cases tended to decrease (202 vs. 130 cases, p = 0.86). The mean patient age increased (60.4 vs. 67.2 years, p < 0.05). There was no difference in the Helicobacter pylori infection rates (92.6% vs. 91.5%, p = 0.89). The number of patients taking oral proton-pump inhibitors (5.9% vs. 26.2%, p < 0.05), oral nonsteroidal anti-inflammatory drugs (17.3% vs. 31.5%, p < 0.05), and oral antithrombotic agents (15.3% vs. 28.5%, p < 0.05) was increased. The number of patients who underwent endoscopic clipping method (73.3% vs. 34.6%, p < 0.05) was reduced. The number of patients who underwent cauterization using hemostatic forceps significantly increased (4.0% vs. 76.2%, p < 0.05). Conclusions: There was no difference in H. pylori infection rates due to the progressive aging of the patients. Fewer cases were treated using endoscopic clipping, whereas more cases were subjected to cauterization using hemostatic forceps.