scholarly journals Surgical treatment of gastroduodenal ulcer bleeding: Our experience

2007 ◽  
Vol 54 (1) ◽  
pp. 165-167
Author(s):  
S.N. Krstic ◽  
T. Alempijevic ◽  
M.N. Krstic ◽  
Z.D. Lausevic ◽  
A. Sijacki ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Gastroduodenal Ulcer ◽  
Treatment Options ◽  
Ulcer Bleeding ◽  
Endoscopic Management ◽  
Ulcer Disease ◽  
Endoscopic Techniques ◽  
Clinical Center ◽  
The Mean ◽  
Gastroduodenal Ulcer Bleeding

Introduction: Acute bleeding from the upper gastrointestinal tract remains the commonest emergency in gastroenterology, and is most often caused by gastroduodenal ulcer disease. Despite introduction of novel endoscopic techniques and pharmacological treatment, 6-15% patients have to be operated. The aim of our investigation is analyze data of patients treated for gastrointestinal ulcer bleeding in our institution, their treatment options and outcome. Patients and methods: We included 2237 patients admitted in the Department for Emergency medicine of Clinical center of Serbia during the period from January 1999 until December 2003. because of gastroduodenal ulcer bleeding. We analyzed age, gender treatment option, hospital stay and mortality. Results: The mean age of our patients was 61.58 years, 1346 male and 891 female. The majority of patients were conservatively treated (84.5%). Operated patients mostly undergo Billroth II resection (57.8%). The mean hospital stay was 7.3 days. Average mortality was 14.4% Conclusions: Despite adequate endoscopic management of bleeding gastroduodenal ulcer, surgeons will continue to treat this patients for emergency surgery.

scholarly journals 322 – Prevention of Recurrent Idiopathic Gastroduodenal Ulcer Bleeding: A 2-Year Double-Blind Randomized Trial (NRT STUDY)

2019 ◽  
Vol 156 (6) ◽  
pp. S-62-S-63
Author(s):  
Louis Ho Shing Lau ◽  
Jessica Y. Ching ◽  
Yee Kit Tse ◽  
Rachel Ling ◽  
Francis K. Chan ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Double Blind ◽  
Gastroduodenal Ulcer Bleeding

Endoscopic Doppler Sonography in gastroduodenal ulcer bleeding

1992 ◽  
Vol 70 (8) ◽  
Author(s):  
D. Jaspersen ◽  
T. K�rner ◽  
J. Wzatek ◽  
W. Schorr ◽  
C.B. Gaster ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Gastroduodenal Ulcer Bleeding

scholarly journals Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 58 ◽  
Author(s):  
Volkan Ulker ◽  
Orcun Celik
Keyword(s):  
Hospital Stay ◽  
Treatment Options ◽  
Operating Time ◽  
Operation Time ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Clavien Grade ◽  
Grade Ii ◽  
The Mean

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions.

scholarly journals APPLICATION OF MODERN METHODS OF ENDOSCOPIC HАEMOSTASIS IN THE TREATMENT OF GASTRODUODENAL ULCER BLEEDING

2021 ◽  
pp. 81-84
Author(s):  
N. M. Honcharova ◽  
P. V. Svirepo ◽  
A. S. Honcharov
Keyword(s):  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Modern Methods ◽  
Anesthetic Risk ◽  
Gastroduodenal Ulcer Bleeding ◽  
Endoscopic Clipping ◽  
Submucosal Infiltration

Summary. The aim of the study is to improve the results of treatment of patients with ulcerative gastroduodenal bleeding by using the methods of endoscopic hаemostasis. Materials and research methods. The results of endoscopic hаemostasis of 153 patients who were treated in the surgical department of the “Regional Clinical Hospital” were analyzed. Patients were examined clinically, laboratory and instrumental. Results and its discussion. For Forrest 1a, b bleeding, endoscopic clipping was used in 16 (10.4 %) patients with a visualized vessel in the bottom of the ulcer. In the studied patients of this group, there were no relapses of bleeding. Diathermy coagulation was used in 42 (27.5 %) patients. Recurrent bleeding was observed in 6 patients. Submucosal infiltration was performed in 37 (24.2 %) patients with ulcerative bleeding. Repeated bleeding was recorded in 9 patients within the next 3 hours after the intervention and in 7 patients during the first days after endoscopic hаemostasis. Combinations of endoscopic methods of hаemostasis were used in 58 (37.9 %) patients. Conclusions. The use of modern methods of endoscopic hаemostasis followed by adequate pharmacotherapy in most cases allows achieving a final stop of bleeding. Patients with a high risk of recurrent bleeding and a low surgical and anesthetic risk after successful endoscopic hаemostasis are shown surgical intervention before the development of recurrent bleeding.

DOZ047.110: Recurrent tracheoesophageal fistula tracheoscopic chemocauterization with trichloroacetic acid

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
D P R Lara ◽  
L V M Riveros ◽  
L R S Pineda ◽  
P O Padilla ◽  
I C Cañón ◽  
...  
Keyword(s):  
Trichloroacetic Acid ◽  
Tracheoesophageal Fistula ◽  
Primary Repair ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Medical Reason ◽  
Endoscopic Techniques ◽  
Number Of Patients ◽  
The Mean

Abstract Objective The aim of this study was to report the experience of two centers in the treatment of recurrent tracheoesophageal fistula (RTEF), by tracheoscopic chemocauterization with trichloroacetic acid (TCA). A surgical approach to RTEF has high morbidity and mortality. Some endoscopic techniques have been developed but nevertheless, optimal treatment is still not determined because of the low number of patients, short term of follow-up, and different techniques. Materials and Methods From January 2016 to March 2019, 12 patients with RTEF were selected for endoscopic management in two centers. Eleven had RTEF after primary repair of esophageal atresia/TEF and one had a second fistula with misdiagnosis, all of them by a thoracotomy approach. In all cases the diagnosis was confirmed by clinical evaluation, esophagram, and bronchoscopy. Under general anesthesia, a rigid pediatric bronchoscope with a 0° rod lens telescope telemonitoring was used to localize and refresh the fistula with a small endoscopy brush of 2–3 mm. Cotton soaked with 50% TCA was applied on the fistula for 30 seconds. The procedure had to be repeated two times. Results Fistulae were closed in 10 patients. The closure was confirmed by esophagram or bronchoscopy after 2 months of the procedure. It remains completely obliterated and the patients are asymptomatic. There were only two patients with progressive decrease in the diameter of the fistula; one patient died for some other medical reason and another patient is being treated. The mean number of procedures in each patient was 1.3, and the follow-up was 12 months on average (2–36). Two patients had bronchospasms as postoperative complication. Conclusion The tracheoscopic chemocauterization of RTEF with the use of 50% TCA is a minimally invasive, safe, and effective technique. It has fewer complications and avoids the morbidity of open surgery.

The value of routine second-look endoscopy in the management of the acute gastroduodenal ulcer bleeding

2009 ◽  
Vol 150 (42) ◽  
pp. 1932-1936 ◽  
Author(s):  
Katalin Szőcs ◽  
Tibor Kárász ◽  
Hussam Saleh ◽  
Andrea Szabó ◽  
Mihály Csöndes ◽  
...  
Keyword(s):  
Gastroduodenal Ulcer ◽  
Ulcer Bleeding ◽  
Second Look ◽  
Gastroduodenal Ulcer Bleeding

A tervezett ellenőrző endoszkópiák szerepe az akut gastroduodenalis fekélyvérző betegek ellátásában mindmáig ellentmondásos. Endoszkópos és klinikai adatokra alapozott rizikócsoport meghatározására van szükség ahhoz, hogy kiválaszthatóak legyenek azok a betegek, akiknél a tervezett ellenőrző endoszkópia stratégiája hasznosnak bizonyulhat. Célkitűzés: A tervezett ellenőrző endoszkópiák klinikai hasznát kívántuk felmérni akut gastroduodenalis fekélyvérző betegeink klinikai és endoszkópos adatainak retrospektív elemzésével. Módszer: Összesen 274 fekélyvérző beteg adatait elemeztük. A tervezett ellenőrző endoszkópiák hatékonyságának lemérésére az újbóli endoszkópos vérzéscsillapító beavatkozások szükségességét használtuk fel. A betegeket a sürgősségi endoszkópia során észlelt Forrest szerinti fekélystádium alapján csoportosítottuk. Eredmények: Az aktívan vérző fekélybetegek (Forrest Ia, Ib) csoportjában a tervezett endoszkópiák alkalmával 23,8%-ban végeztünk újbóli endoszkópos vérzéscsillapítást. Az ércsonkos fekélyesek (Forrest IIa) csoportjában 13,0%-ban, míg a thrombussal fedett fekélyesek (Forrest IIb) körében 13,3%-ban volt szükség újabb endoszkópos hemosztatikus kezelésre az ellenőrző endoszkópiák kapcsán. Bár a beavatkozások gyakorisága közötti különbségek statisztikailag nem szignifikánsak, mégis klinikailag számottevőnek tartható az, hogy az eredetileg aktívan vérző betegek negyedében hasznos volt a tervezett ellenőrző endoszkópia. Következtetés: Az eredmények arra engednek következtetni, hogy a tervezett ellenőrző endoszkópia stratégiája a kezdetben aktívan vérző és nagy újravérzési kockázatú betegek számára kedvezőbb kórlefolyást ígér.

THE EFFICACY OF RECOMBINANT INTERLEUKIN-1Β IN SURGICAL TREATMENT OF ACUTE ULCERATIVE GASTRODUODENAL BLEEDINGS

2019 ◽  
Vol 64 (11) ◽  
pp. 669-669
Author(s):  
Vidadi Agababa Allahverdiyev
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Gastroduodenal Ulcer ◽  
Interleukin 1Β ◽  
Ulcer Bleeding ◽  
Moderate Degree ◽  
Bleeding Gastric Ulcer ◽  
Before And After ◽  
Gastroduodenal Ulcer Bleeding ◽  
Severe Degree

There was reported the results of the use of recombinant interleukin-1β in basic conservative measures in the surgical treatment of acute gastroduodenal ulcer bleeding. Gastric ulcer were in 20 patients, duodenal ulcer in 84 patients and combined ulcers in 16 patients. According to А.А. Шалимов hospitalized patients with mild blood loss were 27, moderate degree - 62 and severe degree - 31 patients. According to J. Forrest, 29 showed active bleeding (F Ia, F Ib), in 67 - unstable hemostasis (F IIa, F IIb, F IIc) and in 24 - F III. Within the framework of differentiated individual-active tactics, patients were operated in emergency (21), urgent (38), delayed (35), and 26 people underwent early planned operations. Patients in the main group (63) after the operation, was included recombinant interleukin-1β to the basic therapeutic measures additionally, taking into account the degree of blood loss and immune disorders. Patients of comparison group (57) before and after surgery received standard basic therapy without immunocorrection. In a comparative aspect, it has been proved that in postoperative period on the background of standard conservative measures, the use of recombinant interleukin-1β positively influences elimination of the secondary immunodeficiency and cytokine imbalance significantly improves the results of surgical treatment.

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