Issue: 2013, Vol. 18, No. 3
Priorities of endoscopic hemostasis as the basis of urgent treatment of gastroduodenal bleeding in hospital environment
- Keywords
- peptic ulcer of gaster and duodenum, surgical service
- Abstarct
- We have lead the comparative analysis of treatment of 727 patients for optimization of their conduct tactics. All of them had chronic ulcers of stomach and duodenum. The first group included 443 patients, where we have performed active surgical approach. Primary endoscopic hemostasis has been done by using electrocoagulation of bleeding vessel or by chipping of ulcer’s edge by Adrenaline solution or by combinating of these two methods. Emergency surgical intervention was done in 139 cases. Most of them were stomach resections (58%). In these situations it was found impossible to stop bleeding by endoscopic methods or the risk of relapse has been marked as very high. The level of postsurgical lethality was 5.6 %, total mortality – 4,97%. The second group consisted of 284 patients. In these cases endoscopic hemostasis has been used as the treatment, diagnostic and preventive hemostatic action. It was performed two times in 48 cases and three times in 8 cases because the relapse of bleeding took place. The surgical operation was performed in 8 cases. Thus in the case of gastroduodenal bleeding the priority of endoscopic hemostasis reduces number of surgical operations from 31,4 to 3,9%. The same time total mortality decreases from 4,97% to 1,76%. It was shown among the patients of comparing groups.
Ларичев