Safer endoscopic gastric mucosal resection: Preoperative proton pump inhibitor administration

Yoshiyuki Watanabe, Naoyuki Kato, Tadateru Maehata, Masaru Okamoto, Takashi Tsuda, Santa Hattori, Shunichi Yamauchi, Kazuhiko Fujita, Satoshi Baba, Shinichi Nakaya, Hiroyuki Inaba, Satoshi Kitajima, Michihiro Suzuki, Hirohumi Niwa, Fumio Itoh

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Background and Aim: Control of bleeding is crucial in improving the safety of endoscopic mucosal resection (EMR), and intragastric acidity has a great impact on hemostasis and blood coagulation. Proton pump inhibitors (PPI) are potent suppressors of gastric acid; however, PPI need to be continuously administered orally for several days, and thus initial effects may be insufficient if PPI is only administered immediately after EMR. The aim of this study was to determine whether preoperative administration of PPI prior to EMR can elevate intragastric acidity, facilitate better control of intraoperative bleeding (complete coagulation and hemostasis), prevent postoperative bleeding, and facilitate healing of artificial ulcers. Methods: A randomized clinical study was conducted in which EMR was performed with or without 1 week of preoperative PPI administration. Results: Artificial ulcers created by EMR healed more rapidly in patients who received preoperative PPI. Conclusions: The results of the study suggest that preoperative administration of PPI before EMR is useful for controlling and preventing bleeding, and for facilitating the healing of artificial ulcers.

Original languageEnglish
Pages (from-to)1675-1680
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume21
Issue number11
DOIs
Publication statusPublished - 2006 Nov

Keywords

  • Complication
  • Endoscopic mucosal resection
  • Intragastric acidity
  • Proton pump inhibitors
  • Ulceration

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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