Impact of programmed second endoscopy with appropriate re‐treatment on peptic ulcer re‐bleeding: A systematic review

Objectives: The aim of the present systematic review is to critically appraise the current evidence from published medical trials on the role of programmed second endoscopy with appropriate therapy on peptic ulcer re‐bleeding. Methods: A systematic review of five prospective randomized controlled trials comparing the effect of programmed second endoscopy against conservative management on peptic ulcer re‐bleeding was carried out. Results: From the meta‐analysis of the combined results from the five trials on the effect of programmed second endoscopy in ulcer bleeding, we found that a programmed second endoscopy with appropriate therapy reduced the number of recurrent bleeding significantly (Peto odds ratio = 1.97, Mantel Haenszel‐Peto P < 0.01). The number of patients needed for treatment with a programmed second endoscopy in order to prevent one recurrent bleeding ranged from four to 11. Conclusion: Programmed second endoscopy with appropriate therapy reduced the number of recurrent bleeding significantly in patients with bleeding peptic ulcers. Individual trials also showed a possible benefit in reduction of the number of surgical interventions.