[Surgical risk in treatment of a bleeding gastroduodenal ulcer in the era of invasive endoscopy].
OBJECTIVE
Objectivization of the asset of the present therapeutic algorithm in patients with haemorrhage from peptic gastroduodenal ulcers using invasive endoscopic and surgical haemostasis.


METHODS
Comparison of quantitatively and qualitatively equivalent groups of 341/318 patients, the first group without application of invasive endoscopy, the second one with its application.


RESULTS
Surgical haemostasis was called for in 12.3/11.6% cases. 92.9/59.5% operations were resections and bionomic operations, the mortality of the patients was 14.3/21.6%, re-operation was necessary in 7.1/13.5% cases. At the time of operation 57.1/78.3% patients were a high risk, the length of the "critical" interval of haemorrhage in the second group increased by 48.3%.


CONCLUSIONS
The present accepted procedure of haemostasis is associated with risks of limited selection of the optimal method of invasive endoscopy, the protraction of the interval of haemorrhage with an adverse rise of the index of the patient's risk, inadequate stabilization of the patient during the interval of haemorrhage and controversial indication of surgery in case of intractable haemorrhage.
Olejník
J
J
Chirurgická klinika SPAM, FNsP akad. L. Dérera, Bratislava, Slovenská republika. olejnik@pobox.sk
Hladík
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016558:Hemostasis, Endoscopic; D006488:Hemostasis, Surgical; D006801:Humans; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate