EVALUATION OF THE CHOICE OF THE METHOD OF HEMOSTASIS IN ACUTE GASTRODUODENAL ULCER BLEEDING CAUSED BY MEDICATION
DOI:
https://doi.org/10.11603/2414-4533.2024.3.14921Keywords:
gastroduodenal ulcer, ulcer bleeding, endoscopic hemostasisAbstract
The aim of the work: to determine the effectiveness of non-operative and operative methods of hemostasis in the treatment of patients with acute gastroduodenal ulcer bleeding caused by taking medications.
Materials and Methods. An analysis of the treatment of 215 patients with acute gastroduodenal ulcer bleeding caused by taking medical preparations was carried out. There were 116 (53.9 %) men and 99 (46.1 %) women. The average age of the patients was 51.4±0.54 years. Conservative methods of hemostasis were used to stop bleeding; injection medicated endoscopic methods of hemostasis, argon plasma coagulation and mechanical methods – endoscopic clipping of vessels in an ulcer. Bleeding that could not be stopped by conservative and endoscopic methods, as well as recurrent bleeding, was subject to surgical correction.
Results and Discussion. In patients with acute gastroduodenal ulcer bleeding caused by taking medical preparations, the main direction of treatment was the appointment of hemostatic and blood replacement therapy. For 202 (93.95 %) patients, the method of stopping bleeding was the use of endoscopic hemostasis: circumcision of the bleeding vessel with vasoconstrictor and sclerosing solutions was performed in 73 (36.14 %) patients, clipping was used in 67 (33.17 %) patients, argon plasma coagulation – in 35 (17.33 %) and the use of combined methods – in 27 (13.37 %) patients. Gastroduodenal ulcer bleedings that could not be stopped by medication and endoscopic methods of hemostasis, as well as recurrent bleedings, were subject to surgical correction. 38 (17.67 %) patients underwent the following operations: ulcer excision – in 17 (44.74 %) patients, ulcer exteriorization – in 8 (21.1 %) patients followed by duodenoplasty and pyloroduodenoplasty, sectoral resection of the stomach – in 6 (15.79 %), gastric resection according to Billroth-I – in 4 (10.53 %) patients, and ulcer stitching – in 3 (7.89 %) patients. Mortality after surgical treatment was 5.58 % (9 patients died after primary operations, and 3 after surgery for recurrent bleeding).
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