Comparison of Hemostatic Effects between a Combination Therapy Including Endoscopic Injection Therapy and Omeprazole and a Single Intravenous Omeprazole Therapy in Patients with Bleeding Peptic Ulcers

Background/Aims: This study was performed to test whether there is some difference between combined endoscopic therapy with PPI infusion and intravenous PPI therapy alone. Methods: A total of seventy-three high-risk patients with ulcer bleeding and non-bleeding visible vessels or fresh adherent clots resistant to irrigation were randomized to medical therapy [intravenous omeprazole therapy alone: 40mg IV per day for 3-5 days] or to endoscopic combination therapy [endoscopic epinephrine (1：10,000 in normal saline) or ethanol injection followed by intravenous omeprazole infusion]. Results: Patients were similar at study entry. Ulcer bleeding recurred in two patients who received combined endoscopic therapy (2/35, 5.7%) while ulcer bleeding recurred in ten patients who received intravenous omeprazole alone (10/38, 26.3%) (p