Impact of a nursing-led peri-endoscopic management protocol on outcomes in patients with peptic ulcer bleeding undergoing therapeutic endoscopy

doi:10.4240/wjgs.118083

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 118083
Published online Jun 27, 2026. doi: 10.4240/wjgs.118083

Impact of a nursing-led peri-endoscopic management protocol on outcomes in patients with peptic ulcer bleeding undergoing therapeutic endoscopy

Hai-Yan Zhang, Jia-Rong Zhang, Yun-Ying Zhuang, Qing-Cheng Wu, Heng Zhang, Yong-De Huang

Hai-Yan Zhang, Jia-Rong Zhang, Yun-Ying Zhuang, Qing-Cheng Wu, Heng Zhang, Yong-De Huang, Department of Gastroenterology, The 910^th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China, Quanzhou 362000, Fujian Province, China

Author contributions: Zhang HY and Huang YD were responsible for study conception, design, data collection, and drafting of the manuscript; Zhang JR and Zhang H participated in data acquisition, statistical analysis, and interpretation of the results; Zhuang YY and Wu QC supervised the study and provided critical revisions of the manuscript for important intellectual content; and all the authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work.

AI contribution statement: We hereby clarify that we have never used ChatGPT, Grammarly, DeepL or any other AI tools to write this manuscript. All the content of this manuscript was written manually by us, without using any AI tools for generation. We independently completed the tasks of language revision, translation and data analysis, without relying on any AI tools. We did not use any AI tools to design the content of the manuscript or interpret the research results.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the PLA Joint Logistic Support Force 910 Hospital, No. 2023 Lun(shen)027.

Clinical trial registration statement: This study was not registered in a clinical trial registry.

Informed consent statement: All study participants or their legal guardians provided written informed consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: No additional data are available.

Corresponding author: Yong-De Huang, MD, Department of Gastroenterology, The 910^th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China, No. 180 Huayuan Road, Fengze District, Quanzhou 362000, Fujian Province, China. zhyy1106@163.com

Received: February 3, 2026
Revised: March 5, 2026
Accepted: April 3, 2026
Published online: June 27, 2026
Processing time: 131 Days and 22.4 Hours

Abstract

BACKGROUND

Nursing-led peri-endoscopic management protocols play an important role in reducing the risk of short-term rebleeding in patients with peptic ulcer bleeding and may also contribute to shorter hospital stays.

AIM

To evaluate the impact of a nursing-led peri-endoscopic management protocol on outcomes in peptic ulcer bleeding treated with therapeutic endoscopy.

METHODS

This prospective randomized controlled trial included 130 patients with peptic ulcer bleeding who underwent therapeutic endoscopy at our hospital, between March 2023 and March 2025. Patients were randomly assigned to an observation group (n = 65) or a control group (n = 65). The observation group received a nursing-led peri-endoscopic management protocol, whereas the control group received routine endoscopic nursing care. Outcomes included rebleeding, hospital stay, blood transfusion volume, complications, and patient satisfaction.

RESULTS

Baseline characteristics were comparable between groups (P > 0.05). Rebleeding rates in the observation group were lower than in the control group at both time points: 6.15% (4/65) vs 18.46% (12/65) on day 7 and 9.23% (6/65) vs 24.62% (16/65) on day 30 (all P < 0.05). Mean hospital stay was shorter in the observation group (6.8 ± 2.1 days vs 8.1 ± 2.6 days; P = 0.002). Mean blood transfusion volume was also lower (1.3 ± 0.9 U vs 1.9 ± 1.1 U; P < 0.05). The incidence of endoscopic complications was lower in the observation group (P < 0.05). Patient satisfaction rate was higher in the observation group, 92.31% (60/65) vs 78.46% (51/65) in the control group (P < 0.05).

CONCLUSION

Nursing-led peri-endoscopic management reduces short-term rebleeding in patients with peptic ulcer bleeding after therapeutic endoscopy, shortens hospital stay, decreases blood transfusion requirements, and improves patient experience, indicating substantial clinical value.

Keywords: Nursing-led peri-endoscopic management protocol; Peptic ulcer bleeding; Therapeutic endoscopy; Rebleeding; Clinical outcomes

Core Tip: This protocol integrates dual-risk stratification for bleeding and sedation or airway complications, checklist-based intraoperative coordination, and a time-anchored early warning and follow-up pathway, enabling nurses to transition from routine assistance to proactive, standardized peri-endoscopic management for patients with peptic ulcer bleeding.