[The treatment in ulcerative hemorrhages in patients with liver cirrhosis and portal hypertension].
Treatment of 34 patients with bleedings from chronic gastroduodenal ulcers associated with cirrhosis of the liver and portal hypertension was analysed. Overall lethality was 41.2%, postoperative lethality was 41.7%. Temporary hemostasis due to a solution of Caprofen used during fibrogastroduodenoscopy allows the operation to be delayed and complex intensive therapy can be performed in patients with hepatic insufficiency. Control medical endoscopic investigations should be performed 4 and 12 hours after admission to the hospital of patients with sub- and decompensated cirrhosis of the liver with portal hypertension and symptoms of unstable hemostasis. The emergency and delayed operative treatment of patients with subcompensated hepatic insufficiency should include organ-saving operations such as vagotomy with pyloroplasty and/or dissection of the ulcer. Operation is indicated to patients with cirrhosis of the liver at the stage of decompensation but if they have evident reappearance of bleeding and in minimal volume. The attainment of final endoscopic hemostasis will allow to avoid surgical interventions intolerable for this category of patients.
Khanevich
M D
MD
Koshevoĭ
A P
AP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004381:Duodenal Ulcer / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D016558:Hemostasis, Endoscopic / Q000379:methods; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000175:diagnosis; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D013276:Stomach Ulcer / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome