Endoscopic Nd:YAG laser therapy in upper gastrointestinal bleeding.
Between 1983 and 1986 thirty-seven patients with upper gastrointestinal bleeding or stigmata of acute bleeding were treated at the Second Department of Surgery with endoscopic laser therapy. The non-contact method was used. The cause of bleeding was gastric ulcer in 13 cases and duodenal ulcer in 5. Two patients had anastomotic ulcer, 6 had a simple ulcer, 7 had telangiectases (Mb. Osler), 2 had Mallory Weiss tears and 2 bled after gastric biopsy. Twenty-one patients bled during endoscopy and 16 had signs of recent bleeding. During acute bleeding laser treatment was effective in 95% (1, 3). However, 41% of all patients (15/37) rebled within a week after laser therapy and in 30% (11/37) an emergency operation was necessary. The overall mortality rate was 10.8% (4/37). Endoscopic laser coagulation is successful in the initial treatment of acute upper GI-bleeding. However, there is a considerable risk of rebleeding. Acute laser therapy may change an emergency operation into an elective one, provided that the group at risk of rebleeding can be anticipated at first endoscopy.
Hahl
J
J
Second Department of Surgery, University Central Hospital, Helsinki, Finland.
Ovaska
J
J
Kalima
T
T
Schröder
T
T
D004381:Duodenal Ulcer / Q000150:complications; D004724:Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008028:Light Coagulation; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000601:surgery*; D012008:Recurrence; D013276:Stomach Ulcer / Q000150:complications