Randomised trial of endoscopic argon laser photocoagulation in bleeding peptic ulcers.

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Abstract
Emergency endoscopy on 332 patients with acute upper gastrointestinal bleeding showed that 178 had peptic ulcers; 28 of these were actively bleeding (spurting) and 108 showed stigmata of recent hemorrhage (vessels or spots in the ulcer base) suggesting a risk of rebleeding. These 136 patients were randomly allocated to Ar laser photocoagulation or to no additional therapy (controls) at the time of initial endoscopy. All patients received conventional management and the controlling clinicians did not known whether or not the laser was used in any individual patient. The laser system proved simple and safe in use. Initial hemostasis was achieved by the laser in 10 of 15 spurting vessels, but 4 of 13 control spurting vessels also stopped bleeding spontaneously. Overall, there were no statistically significant differences between the laser-treated and control groups in terms of rebleeding, the need for surgical intervention or death. These results require amplification in larger trials and comparison with other studies using different protocols and other hemostatic methods.