Peptic ulcers are common clinical problems characterized by the presence of lesions on the mucous surface of the stomach and duodenum. Initial upper endoscopy (within the first 24 hours of visit) is recommended in most patients because it both confirms the diagnosis and determines targeted endoscopic treatment including epinephrine injection, heat coagulation, using clamps and bandages. Argon plasma coagulation (APC) is a new method that provides non-contact controlled electrocoagulation therapy. Another method is to use hemoclips, especially in active large vessels, which is useful. And thermal probe devices directly or indirectly produce heat and pass electric current through the tissue.

In this study, there are 60 patients in 3 groups with complications of upper gastrointestinal bleeding due to gastric and duodenal ulcers who referred to the gastroenterology department of Towhid Sanandaj Hospital in the period of one year from April 1400 to April 1401. Patients with symptoms of upper gastrointestinal bleeding underwent a 12-hour endoscopy, and if the endoscopy result showed the presence of gastric ulcer with bleeding, they were included in this study. Then diluted epinephrine (1 to 10000) was injected in the amount of 5 to 10 ml in and around the bleeding area. After epinephrine injection, the patients were treated with one of 3 standard endoscopic treatment methods. The APC method was performed using the APC device of ERBE Company (model APC2 VIO 200 D). In the method of using thermal probes, APC device is also used, and Boston Scientific Gold thermal probes, which are installed and operated on the device, were used. Hemoclips method was performed using stainless steel hemoclips. After hemostasis is established, the bleeding site is observed for 4 minutes. After endoscopic treatment, patients were carefully examined. Examination for rebleeding 24 hours later using endoscopy was performed in all three groups by a gastroenterology and liver subspecialist.

The patients participating in this study were at least 21 years old and at most 99 years old, and their average age was 57.49 ± 17.84. In this study, there were 49 men (80.3%) and 12 women (19.7%). There was no significant difference between the three study groups in terms of slow effect and initial hemostasis, as well as the incidence of rebleeding (P>0.05). Among the investigated variables in three groups, endoscopic findings, wound size and final result were significant (P<0.05) and other investigated variables (demographic variables, diagnosis, rebleeding, response to treatment, wound site and D1 site) in All three groups were not significant.

seems that none of these three standard methods have any difference in terms of hemostasis occurrence variables and rebleeding. Also, in patients with gastrointestinal bleeding, the size of the wound, the final result, and the endoscopic findings are very important due to their significance, and officials, practitioners, and treating doctors should pay special attention to these matters.