Abstract
Nd-YAG laser photocoagulation and bipolar electrocoagulation may be useful for controlling upper gastrointestinal bleeding or preventing rebleeding from ulcers with visible vessels. To determine if one of these methods is superior to the other, data from a small randomized trial and from a nonrandomized experience were evaluated. Altogether, 33 patients underwent 37 coagulation sessions; 19 of the patients were randomized (8 laser and 11 bipolar). In the randomized group, 47.4% had no rebleeding after therapy (laser=37.5% and bipolar=54.5%, P>0.1). In the nonrandomized group 56.8% had no further bleeding. Eleven (33%) of the patients required surgery. No patients died of bleeding or complications related to the study. From these data and those in the literature, it is concluded that the Nd-YAG laser and the bipolar coagulator are equally effective for the treatment of solitary upper gastrointestinal bleeding lesions. Since the bipolar unit is cheaper and more easily transported than the laser unit, it may be the method of choice for cauterizing upper gastrointestinal sources until a more effective method is developed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Morrissey JF, Winans CS: Controversies in Gastroenterology. Am J Dig Dis 22:534–540, 1977
Graham DY: Limited value of early endoscopy in the management of acute upper gastrointestinal bleeding. Am J Surg 140:284–290, 1980
Peterson WL, Barnett CC, Smith HJ, Allen MH, Corbett DB: Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized controlled trial. N Engl J Med 304:925–929, 1981
Protell RL, Gilbert DA, Silverstein FE, Jensen DM, Hulett FM, Auth DC: Computer-assisted electrocoagulation: Bipolar vs monopolar in the treatment of experimental canine gastric ulcer bleeding. Gastroenterology 80:451–455, 1981
Machicado GA, Jensen DM, Tapia JI, Mautner W: Treatment of bleeding canine duodenal and esophageal ulcers with argon laser and bipolar electrocoagulation. Gastroenterology 81:859–865, 1981
Johnston JH, Jensen DM, Mautner W: Comparison of endoscopic electrocoagulation and laser photocoagulation of bleeding canine gastric ulcers. Gastroenterology 82:904–910, 1982
Vallon AG, Cotton PB, Laurence BH, Armengol Miro JR, Salord Oses JC: Randomised trial of endoscopic argon laser photocoagulation in bleeding peptic ulcers. Gut 22:228–233, 1981
Swain CP, Storey DW, Northfield TC, Bown SG, Kirkham JS, Salmon PR: Controlled trial of argon laser photocoagulation in bleeding peptic ulcers. Lancet 2:1313–1316, 1981
Ihre T, Johansson C, Seligson U, Torngren S: Endoscopic YAG-laser treatment in massive upper gastrointestinal bleeding. Report of a controlled randomized study. Scand J Gastroenterol 16:633–640, 1981
Rutgeerts P, Vantrappen G, Broeckaert L, Janssens J, Coremans G, Geboes K, Schurmans P: Controlled trial of YAG laser treatment of upper digestive hemorrhage. Gastroenterology 83:410–416, 1982
MacLeod IA, Mills PR, MacKenzie JF, Joffe SN, Russell RI, Carter DC: Neodymium yttrium aluminum garnet laser photocoagulation for major haemorrhage from peptic ulcers and single vessels: A single blind controlled study. Br Med J 286:345–348, 1983
Rutgeerts P, Vantrappen G, Broeckaert L, Coremans G, Janssens J, Geboes K: A new and effective technique of YAG laser photocoagulation for severe upper gastrointestinal bleeding. Endoscopy 16:115–117, 1984
Kajiro K, Yamamoto H, Matsui H, Tsujimura D, Yamamoto T, Hirooka T, Todo A: Endoscopic bipolar electrocoagulation in upper gastrointestinal bleeding. Endoscopy 16:6–9, 1984
Kernohan RM, Anderson JR, McKelvey STD, Kennedy TL: A controlled trial of bipolar electrocoagulation in patients with upper gastrointestinal bleeding. Br J Surg 71:889–891, 1984
Donahue PE, Mobarhan S, Layden TJ, Nyhus LM: Endoscopic control of upper gastrointestinal hemorrhage with a bipolar coagulation device. Surg Gynecol Obstet 159: 113–118, 1984
Storey DW, Bown SG, Swain CP, Salmon PR, Kirkham JS, Northfield TC: Endoscopic prediction of recurrent bleeding in peptic ulcers. N Engl J Med 305:915–916, 1981
Griffiths WJ, Neumann DA, Welsh JD: The visible vessel as an indicator of uncontrolled or recurrent gastrointestinal hemorrhage. N Engl J Med 300:1411–1413, 1979
Johnston JH, Sones JQ, Long BW, Posey EL: Comparison of heater probe and YAG laser in endoscopic treatment of bleeding from peptic ulcers. Gastrointest Endosc 31: 175–180, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Goff, J.S. Bipolar electrocoagulation versus Nd-YAG laser photocoagulation for upper gastrointestinal bleeding lesions. Digest Dis Sci 31, 906–910 (1986). https://doi.org/10.1007/BF01303209
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01303209