Endoscopic-morphological assessment of hemostasis in bleeding Gastrododenal ulcers
DOI:
https://doi.org/10.11603/2414-4533.2021.4.12717Keywords:
endoscopic hemostasis, gastroduodenal ulcer, bleedingAbstract
The aim of the work: to evaluate endoscopic and morphological criteria of bleeding activity with prediction of the probability of its recurrence in the case of chronic active gastroduodenal ulcer.
Materials and Methods. The endoscopic picture in 378 patients with chronic bleeding ulcers of the stomach and duodenum according to the Forrest classification was analyzed. There were 257 male patients (67.98 %) and 121 female patients (32.02 %). Of Forest IA, IB, IIA, IIB, IIS, there were 231 (61.11 %) patients who underwent endoscopic hemostasis (injection therapy or argonoplasmic coagulation). In 147 (38.89 %) patients, hemostasis was not performed due to the endoscopic picture of bleeding activity in Forest III. Biopsy was taken from the area of periulcerative infiltrate during endoscopic diagnosis before hemostasis on the day of admission to the hospital. Histological material was fixed in formalin solution, prepared microscopic slides stained with hematoxylin and eosin. The calculation of the study data was performed on the basis of the use of standard software products “Statistica”.
Results and Discussion. A comparative evaluation of endoscopic hemostasis methods revealed the advantages of argonoplasmic coagulation over injection methods, which can be interpreted as the “gold standard” when choosing the method of endoscopic hemostasis. The prospect of the study is the choice of surgical tactics depending on the prognosis of the likelihood of recurrence of bleeding, depending on the quantitative ratio of reparative and destructive cells in biopsies of ulcerative infiltration in patients with unstable hemostasis.
References
Feinman, M., & Haut, E.R. (2014). Upper gastrointestinal bleeding. Surg. Clin. North Am., 94 (1), 43-53.
Khadzhibaev, A.M., Iu, R.M., Kholmatov, R.M., Melnik, I.V., & Allaiarov, U. D. (2005). The role of endoscopy in diagnosis and treatment of gastroduodenal bleedings. Khirurgiia, (4), 24-27.
Maggio, D., Barkun, A.N., & Martel, M. (2013). Predictors of early rebleeding after endoscopic therapy in patients with nonvariceal upper gastrointestinal bleeding secondary to high-risk lesions. Can. J. Gastroenterol., 27 (8), 454-458.
Semeniuk, Yu.S., Bodnar, P.Ya., & Minich, V.H. (2013). Morfolohichni osoblyvosti slyzovykh obolonok shlunka ta dvanadtsiatypaloi kyshky u khvorykh na vyrazkovu khvorobu, uskladnenu hostroiu retsydyvnoiu shlunkovo-kyshkovoiu krovotecheiu [Morphological features of the mucous membranes of the stomach and duodenum in patients with peptic ulcer disease complicated by acute recurrent gastrointestinal bleeding]. Visnyk naukovykh doslidzhen – Bulletin of Scientific Research, (4), 49-50 [in Ukrainian].
Stanley, A.J., & Laine, L. (2019). Management of acute upper gastrointestinal bleeding. BMJ, 364.
Tsoi, K.K., Chan, H.C., Chiu, P.W., Pau, C.Y., Lau, J.Y., & Sung, J.J. (2010). Second‐look endoscopy with thermal coagulation or injections for peptic ulcer bleeding: A meta‐analysis. Journal of Gastroenterology and Hepatology, 25 (1), 8-13.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
