SURGICAL TACTICS IN ULCEROUS GASTROINTESTINAL HEMORRHAGES

Aim. To analyze the results of surgical treatment of gastrointestinal hemorrhages. Materials and methods. The results of treatment of 464 patients with hemorrhages from chronic gastric and duodenal ulcers were analyzed by us. Patients were divides into two groups depending on treatment. In group 1 (control, n =111), treatment of ulcerous hemorrhages was performed with traditional techniques, in group 2 (main, n =353) - morphological and histological status of vessels and architectonics in the zone of ulcer was studied. The type of hemorrhage (arterial or venous) can be used as a criterion for determination of surgical tactics in ulcerous gastroduodenal hemorrhages. Results. According to the type of hemorrhage, patients were distributed in the following way: 58 (16,4 %) had arterial hemorrhage, but 295 (83,6 %) - venous. Differential diagnosis was carried out by clinical, endoscopic and laboratory data. For the first time, the method for assessment of significance of using the type of hemorrhage for determination of surgical tactics in ulcerous gastroduodenal hemorrhages was developed (RF Patent Invention №2407445; 27.10.2010). Conclusions. Efficiency of conservative therapy was on average 80%: venous hemorrhage - 78,2%, arterial - 1,8%. So, it needs to use an active surgical tactics for patients with arterial type of hemorrhage and active-differential one - for those with venous type of hemorrhage.

Ulcerous gastroduodenal hemorrhages, gastric and duodenal ulcer, gastrointestinal hemorrhages