Brief Article
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World J Gastroenterol. Aug 7, 2011; 17(29): 3441-3447
Published online Aug 7, 2011. doi: 10.3748/wjg.v17.i29.3441
Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy
Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Kee Tae Park, Gwang Ha Kim, Geun Am Song, Mong Cho
Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Kee Tae Park, Gwang Ha Kim, Geun Am Song, Mong Cho, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Yangsan-si, Gyeongsangnam-do 626-770, South Korea
Author contributions: Choi CW and Kang DH contributed to conception and design, analysis and interpretation of the data; Kim HW, Park SB, Park KT, Kim GH, Song GA and Cho M collected data; Song GA and Cho M revised the article; all authors approved the final version of the paper.
Supported by A grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea NO. A091047 and Medical Research Institute Grant (2009-1), Pusan National University
Correspondence to: Dae Hwan Kang, MD, PhD, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 626770, South Korea. sulsulpul@yahoo.co.kr
Telephone: +82-55-3601535   Fax: +82-55-3601536
Received: November 15, 2010
Revised: January 18, 2011
Accepted: January 25, 2011
Published online: August 7, 2011
Abstract

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 (250 μg/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.

Keywords: Somatostatin; Pantoprazole; Gastrointestinal bleeding; Rebleeding