The role of endoscopic doppler probe in the management of bleeding peptic ulcers: A systematic review and meta-analysis.

Objectives: Forrest classification for ulceration has significant intra and inter-observer variability. The endoscopic doppler probe (DOP-US) identifies arterial blood flow at the base to direct therapy. We performed a systematic review and meta-analysis to evaluate the role of the DOP-US in bleeding peptic ulcers. Methods: Three independent reviewers performed a comprehensive review of all original articles published from inception to December 2019, evaluating the use of DOP-US in peptic ulcer bleeding. Primary outcomes were the comparison of rebleeding rate, mortality and surgical intervention in patients with DOP-US signal guided therapy versus standard visual evaluation guided therapy. Results: Eight studies were included after a thorough search was concluded using the key words. The use of DOP-US probe decreases rebleeding, mortality and surgical intervention as compared to Forrest Classification. The risk of rebleeding is significantly higher if the signal persists despite endoscopic therapy (48.5% (95% CI 29.5-67.9%). Conclusion: The first systematic review and meta-analysis showed that the DOP-US is a beneficial tool in the management of bleeding ulcers and adds valuable information to visual evaluation.