Surgery treatment at ulcer gastroduodenal bleedings

Abstract

Background. Gastroduodenal bleeding is one of the most dangerous complications of ulcer and it makes up 60 % of all bleedings from upper digestive tract. Methods. It was conducted the retrospective analysis of treatment results of 418 patients with acute ulcer gastroduodenal bleedings for 2007-2012 in 2 Vladivostok clinical hospital. Assessing the hemostasis it was used the classification of J.A. Forrest (1974). Results. 58 patients (13,9 %) were admitted to hospital with the bleeding of group Forrest I, the bleeding recurrence was detected in 15 of them (25,9 %); of group Forrest II - 213 patients (51 %), recurrence - in 21 (9,8 %); of group Forrest III - in 147 patients (35,1 %), recurrence - in 5 (3,4 %). 46 patients were undergone the surgery (11 %): 38 (9,1 %) - emergency surgery, 8 (1,9 %) - elective surgery. The rate of mortality after emergency surgery was 10,6 %. There was no mortality after elective surgery. 19 patients of 418 died 19 (4,5 %): at gastric ulcer - 9 of 166 (5,4 %), at peptic ulcer - 10 of 234 (4,3 %). Conclusions. The usage of combined methods of endohemostasis and conservative antiulcer and hemostatic therapy enable to reduce the risk of bleeding recurrence, to reduce the number of emergency surgery (to 9,1 %) and mortality at continuous pathology (to 4,5 %).