الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The endoscopic hemoclip method is a safe and effective haemostatic method for managing bleeding peptic ulcer. We compared the haemostatic efficacy of the endoscopic hemoclip method with that of hypertonic saline-epinephrine (HSE) and histoacryl injection in the management of bleeding peptic ulcer. from August 2001 to July 2002, we concluded a randomized clinical trial of endoscopic haemostasis involving 40 patients with actively bleeding, black ulcer base or adherent clot at endoscopic inspection, they divided into 4 groups. Patients were randomly assigned to medical therapy (10 patients), hemoclip application (10 patients), histoacryl injection (10 patients) and HSE injection (10 patients). Initial haemostaiss was achieved in 90 % in hemoclip group , 100 % in histoacryl and adrenaline group and no one in medical group. Rebleeding developed in 40%, 10%, 20% and 20% of case respectively. Emergency surgery were performed in 10%, 10%, 20% and 10% of cases. permanent haemostasis was 60 %, 90%, 80% and 90% of cases. No local or systemic complication attributable to injection or clip placement were found. The hemoclip placement although a very expensive, difficult technique, yet it was more effective, safe and superior to injection therapy with HSE and histoacryl.