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Published on: March 25, 2022
[Endoscopic treatment of bleeding gastroduodenal ulcers]
Insights
Gastrointestinal endoscopic treatment effectively manages bleeding gastroduodenal ulcers, achieving high hemostasis rates and significantly reducing the need for surgical intervention in most patients.
Area of Science:
- Gastroenterology
- Endoscopic interventions
- Gastrointestinal bleeding management
Context:
- Bleeding gastroduodenal ulcers pose a significant clinical challenge.
- Surgical intervention has historically been the primary treatment for severe cases.
- The efficacy of endoscopic therapy as an alternative requires thorough evaluation.
Purpose:
- To evaluate the effectiveness of gastrointestinal (GI) endoscopic treatment for bleeding gastroduodenal ulcers.
- To determine if endoscopic therapy can decrease the requirement for surgical procedures.
- To assess hemostasis rates achieved through endoscopic interventions.
Summary:
- A retrospective study analyzed 122 patients with bleeding gastroduodenal ulcers treated between 1995-1997.
- 72 patients underwent endoscopic therapy (injection or electrocoagulation), achieving 94% primary hemostasis.
- Definitive hemostasis was achieved in 79% of patients, with no direct treatment complications observed.
Impact:
- Endoscopic treatment offers a viable alternative to surgery for bleeding gastroduodenal ulcers.
- Successful endoscopic hemostasis can avert the need for invasive surgical procedures.
- This approach improves patient outcomes by providing effective, less invasive treatment options.
Introduction:
The aim of this study was to assess the extent to which GI endoscopic treatment of bleeding gastroduodenal ulcers is effective and whether it could reduce the need for surgery.
Methods:
A retrospective evaluation was carried out. Over a period of three years (1995-1997), 122 patients with bleeding caused by a gastroduodenal ulcer, defined as fresh haematemesis with or without melaena, old haematemesis with melaena or melaena accompanied by a systolic blood pressure below 80 mmHg, underwent emergency GI endoscopy. Endoscopic therapy consisted of either injection therapy or electrocoagulation.
Results:
Altogether 72 patients received endoscopic treatment. Primary haemostasis was achieved in 94%. Definitive haemostasis after one endoscopic treatment with either injection therapy or electrocoagulation was achieved in 63% and 62%, respectively. Including repeated endoscopic treatment, definitive haemostasis was achieved in 79%. No direct complications of the treatment were observed.
Discussion:
Endoscopic treatment of bleeding gastroduodenal ulcers is the only alternative to an operation. Endoscopic treatment can reduce the need for surgery, as it was effective in about 80% of the patients.
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