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On the Probability of Recurrent Endoscopic Hemostasis in Recurrent Ulcerous Gastroduodenal Bleeding

Bibliography link: Lebedev N. V., Klimov A. E., Persov М. Yu., Petukhov V. A. On the Probability of Recurrent Endoscopic Hemostasis in Recurrent Ulcerous Gastroduodenal Bleeding. Doctor.Ru. 2018; 3(147): 23–26.
On the Probability of Recurrent Endoscopic Hemostasis in Recurrent Ulcerous Gastroduodenal Bleeding
20 March 14:38

Study Objective: to study the rationale of recurrent endoscopic hemostasis in recurrent ulcerous bleeding.

Study Design: perspective study.

Materials and Methods. The study enrolled 1,360 patients with ulcerous gastroduodenal bleeding.770 patients (56.6%) were prescribed endoscopic hemostasis.590 patients (43.4%) did not have any indications for endoscopic hemostasis due to a low risk of recurrent bleeding as per Forrest IIC or due to the absence of signs of past bleeding as per Forrest III.

Study Results. Out of 770 patients, recurrent bleeding was observed in 162 patients (21%); and efficient recurrent hemostasis was performed in 122 patients (75.3%).In 40 cases (24.7%) there were indications for surgery. Out of 162 patients, 46 patients (28.4%) died of recurrent bleeding; out of 40 patients who underwent surgery, 18 patients (45%) died, whereas after the use of endoscopic hemostasis there were (n = 122) 28 (22.9%) deaths. The lowest efficiency and a larger number of deaths was recorded after injection hemostasis. The highest efficiency with the minimal number of deaths was observed after combined endoscopic hemostasis (CEH).

Use of combined endoscopic hemostasis in recurrent bleeding with the severity level of over 17 points as per Simplified Acute Physiology Score II resulted in significant reduction in the number of deaths (р < 0.05).

Conclusion. CEH is significantly more efficient in recurrent bleeding arrest as compared to injection hemostasis; there are no significant difference between CEH and argon-plasma and radio-wave coagulation. For recurrent bleeding, recurrent endoscopichemostasis is a real alternative to surgery, especially in somatically severe cases.

N. V. Lebedev — People’s Friendship University of Russia, Moscow. E-mail: persov@yandex.ru

A. E. Klimov — People’s Friendship University of Russia, Moscow. E-mail: persov@yandex.ru

М. Yu. Persov — People’s Friendship University of Russia, Moscow. E-mail: persov@yandex.ru

V. A. Petukhov — People’s Friendship University of Russia, Moscow. Municipal Clinical Hospital No. 64 of the Moscow Department of Health. E-mail: persov@yandex.ru

On the Probability of Recurrent Endoscopic Hemostasis in Recurrent Ulcerous Gastroduodenal Bleeding
20 March 14:38
LITERATURE
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