The Surgeon’s Risks during Treatment of a Bleeding Gastroduodenal
Ulcer in the Era of Invasive Endoscopy
Olejník J., Hladík M.
Chirurgická klinika SPAM, FNsP akad. L. Dérera, Bratislava, Slovenská republika, prednosta prof. MUDr. S. Haruštiak, CSc. |
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Summary:
Objective: Objectivization of the asset of the present therapeutic algorithm in patients with haemorrhage
from peptic gastroduodenal ulcers using invasive endoscopic and surgical haemostasis.
Method: Comparison of quantitatively and qualitatively equivalent groups of 341/318 patients, the first group
without application of invasive endoscopy, the second one with its application.
Results: Surgical haemostasis was called for in 12.3/11.6% cases. 92.9/59.5% operations were resections and
bionomic operations, the mortality of the patients was 14.3/21.6%, re-operation was necessary in 7.1/13.5% cases.
At the time of operation 57.1/78.3% patients were at high risk, the length of the „critical“ interval of haemorrhage
in the second group increased by 48.3%.
Conclusions: The present accepted procedure of haemostasis is associated with risks of limited selection of
the optimal method of invasive endoscopy, the protraction of the interval of haemorrhage with an adverse rise of
the index of the patient’s risk, inadequate stabilization of the patient during the interval of haemorrhage and
controversial indication of surgery in case of intractable haemorrhage.
Key words:
haemorrhage from peptic ulcer – endoscopic haemostasis – surgical haemostasis – bionomic
operation – resection
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