Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy

• Published in: World journal of gastroenterology : WJG Vol. 17; no. 29; pp. 3441 - 3447
• Main Authors: Choi, Cheol Woong, Kang, Dae Hwan, Kim, Hyung Wook, Park, Su Bum, Park, Kee Tae, Kim, Gwang Ha, Song, Geun Am, Cho, Mong
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 07.08.2011
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Aged; Aged, 80 and over; Anti-Ulcer Agents - therapeutic use; Brief; Databases, Factual; Gastrointestinal Hemorrhage - prevention & control; Gastrointestinal Hemorrhage - therapy; Hemostasis, Endoscopic - methods; Humans; Male; Middle Aged; Recurrence; Retrospective Studies; Somatostatin - therapeutic use; Treatment Outcome; Upper Gastrointestinal Tract - pathology; Upper Gastrointestinal Tract - surgery; 上消化道出血; 内镜; 多因素分析; 张性; 生长抑素; 辅助治疗; 静脉滴注; 风险因素; Rebleeding; Somatostatin; Pantoprazole; Gastrointestinal bleeding
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v17.i29.3441

AIM：To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding（NVUGIB）.METHODS：We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion（8 mg/h for 72 h）.The somatostatin adjunct group（n=49）also received a 250-μg bolus of somatostatin,followed by continuous infusion （250μg/h for 72 h）.Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS：Early rebleeding rates were not significantly different between treatment groups（12.2%vs 14.3%,P=0.766）.Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups（94.2%vs 95.9%,P=0.696）.Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding（P =0.044,OR：9.080,95%CI：1.062-77.595）.CONCLUSION：The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.