Endoscopic treatment of gastrointestinal bleeding with gelatin sponge.

Abstract

Background and study aims: Solid gelatin sponge is widely used in surgery but cannot be used endoscopically. A fluid gelatin sponge (FGS) was prepared for this research.

Material and methods: The hemostatic effect of the FGS on gastrointestinal wound bleeding was evaluated through pig experiments. One bleeding ulcer was randomly sprayed with FGS, and the other bleeding ulcer was sprayed with normal saline. Endoscopy was performed after 2 h, 3 days, and 14 days for the evaluation of the hemostatic effect and the quality of ulcer healing. At 14 days, the central tissue of the ulcer was biopsied. In addition, FGS dynamic coagulation and gastric juice mixing experiments were performed in vitro.

Result: The FGS group had a higher initial hemostasis success rate and shorter hemostasis time than the NC group. The rebleeding rate of ulcer was significantly higher in the NC group than that in the FGS group (75 % vs. 25 %). Fourteen days after the operation, the ulcer healing quality in the FGS group was significantly better than that in the control group. The degree of inflammation and fibrosis of ulcer tissues in the FGS group was lower, whereas microvessel density was higher. In addition, IL-6 mRNA levels in ulcerated tissues of the FGS group were not significantly different from those in the NC group and normal group (P>0.05).

Conclusion: The adoption of self-made FGS under endoscopy achieved a good hemostatic effect on intestinal bleeding wounds, inhibiting rebleeding and accelerating wound healing.