Endoscopic adrenaline injection was shown to reduce the need for blood transfusion and surgery. In 1997, the British Medical Journal again reported that the Centre combined adrenaline injection and the thermal method of heater probe in treating bleeding peptic ulcers. The combined method further improved the efficacy of endoscopic therapy. Now only about 3 to 4 per cent of patients require surgery, one of the lowest in the world. The overall mortality has been consistently around 4 to 5 per cent compared to the average of 10 per cent reported by centres in the West.
Endoscopic therapy is especially applicable to elderly patients.
In an aging population, patients with the condition are often elderly patients with co-morbid illnesses. The applicability of endoscopic therapy in bleeding peptic ulcer is greatly enhanced with the discovery of Helicobacter pylori and powerful ulcer healing drugs such as proton pump inhibitors. Endoscopic therapy stops bleeding and these drugs heal peptic ulcers and more importantly prevent their recurrences. The Chinese University of Hong Kong recently concluded a 3-year long clinical trial at the Prince of Wales Hospital. During this period, over 3,500 patients were admitted for peptic ulcer bleeding and a third of them received the combined adrenaline injection and heater probe treatment.