Upper gastrointestinal hemorrhage--surgical aspects.
During the last decades, significant advantages have been achieved with the use of emergency endoscopy and respective hemostatic interventions. Rebleeding, however, remains a significant clinical problem, and currently re-endoscopy or surgical intervention offers advantages and disadvantages. With the discovery of Helicobacter pylori as a main causative factor behind peptic ulcer disease, a more conservative surgical approach is mandated even in situations with significant rebleeding. In case of large gastric ulcer, however, resection is a wise strategy depending on the risk of malignancy. Liver transplantation has immensely improved the prognoses for variceal bleeding in end-stage liver disease in carefully selected patients.
Lundell
Lars
L
Department of Surgery, Huddinge University Hospital, Stockholm, Sweden. lars.lundell@hs.se
D004381:Duodenal Ulcer / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006801:Humans; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013276:Stomach Ulcer / Q000150:complications