title: Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding.
abstract: OBJECTIVE
  To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract.
  
  
  METHODS
  A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed.
  
  
  RESULTS
  Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17 ) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE.
  
  
  CONCLUSIONS
  TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.
authors.affiliation: Departments of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: R F
authors.initials: RF
authors.lastname: Jailani
authors.affiliation: Departments of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N R
authors.initials: NR
authors.lastname: Kosai
authors.affiliation: Departments of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N Y
authors.initials: NY
authors.lastname: Yaacob
authors.affiliation: Departments of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: R
authors.initials: R
authors.lastname: Jarmin
authors.affiliation: Institute of Translational Medicine, University of Liverpool, UK.
authors.forename: P
authors.initials: P
authors.lastname: Sutton
authors.affiliation: Departments of 1Surgery, and 2Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: H
authors.initials: H
authors.lastname: Harunarrashid
authors.affiliation: Department of Vascular Surgery, Edinburgh Royal Infirmary, UK.
authors.forename: J
authors.initials: J
authors.lastname: Murie
authors.affiliation: Department of Anatomy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: S
authors.initials: S
authors.lastname: Das
mesh_terms: D000792:Angiography; D004621:Embolization, Therapeutic; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies
keywords: Angioembolization; Embolization; Surgery; Transarterial; Transcatheter