Endoscopic electrocoagulation of major @entity548 from peptic XXXX .

@entity1 @entity548 @entity1066 @entity4773 @entity2210 @entity2275
Endoscopic electrocoagulation with a liquid monopolar probe was exclusively attempted in 77 @entity1 with major @entity548 from peptic @entity1066 assessed as requiring emergency surgery. Endoscopy failed to control @entity548 in 14 @entity1 (18%), who proceeded directly to surgery. Initial endoscopic hemostasis was obtained in 63 @entity1 , but @entity548 recurred in 18 (29%). Rebleeding required surgery in 11 @entity1 and another @entity1 died prior to surgery. Permanent endoscopic control was achieved in 51 @entity1 (66%). Without difference in transfusion requirement, endoscopy was most likely to succeed in @entity1 with superficial acute @entity1066 , onset of @entity548 in hospital, @entity2275 , no earlier history of @entity2210 and in @entity1 with previous @entity1066 surgery. Endoscopy was less likely to succeed in @entity1 with @entity4773 , though it controlled major @entity548 in more than half of such @entity1 . Profuse @entity548 , and in particular poor access in a narrowed duodenal bulb, were important determinants of endoscopic failure. Of the @entity1 with permanent endoscopic hemostasis, 8% subsequently underwent elective @entity1066 surgery. Endoscopic electrocoagulation is safe and has potential to control major @entity548 , obviating emergency surgery, in two-thirds of the cases. As the less invasive method, endoscopy should be attempted before surgery, particularly in @entity1 regarded as poor surgical risks or with no history of @entity2210 .
