Khirurgiia · 2026
[Endovascular methods for prevention and treatment of upper gastrointestinal bleeding].
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Vasiliev A V, Antipov E A, An E S, Tsarev M I, Anderzhanova A A, Meleshkina Yu A, Lukina M V
Аннотация
OBJECTIVE: To analyze effectiveness and safety of transcatheter arterial embolization for the treatment of upper gastrointestinal bleeding and compare these results with national and international data.
MATERIAL AND METHODS: A retrospective analysis of local database included patients with gastroduodenal bleeding for the period from 08.2022 to 12.2024. There were 48 patients including 28 (58.3%) men and 20 (41.6%) women. Mean age of patients was 67.9±11.4 years. Own results were compared with national and international data.
RESULTS: There were the following causes of bleeding: various gastric and duodenal tumors - 30 (62.5%); acute and chronic gastric and duodenal ulcers - 16 (33.3%); erosive gastritis, esophagitis - 3 (6.25%). Primary inefficiency of endoscopic hemostasis was noted in 7 patients. In other 41 patients, endoscopic hemostasis was effective. Technical success rate was 100% (48 patients). Recurrence of bleeding was observed in 2 (4%) patients after 2 and 11 days. There was 1 complication (shoulder hematoma without necessary surgical correction). Mean hospital-stay was 15 days. Mortality rate was 33.3% (n=16); 32 (66.7%) patients were discharged.
CONCLUSION: Transcatheter arterial embolization is a quick, safe and effective minimally invasive alternative to surgery, when endoscopic treatment does not allow upper gastrointestinal bleeding control. The advantages of arterial embolization are feasibility of this method in high risk patients, combination of diagnostic angiography to identify the cause of bleeding, rapid hemostasis compared to other instrumental methods.
MATERIAL AND METHODS: A retrospective analysis of local database included patients with gastroduodenal bleeding for the period from 08.2022 to 12.2024. There were 48 patients including 28 (58.3%) men and 20 (41.6%) women. Mean age of patients was 67.9±11.4 years. Own results were compared with national and international data.
RESULTS: There were the following causes of bleeding: various gastric and duodenal tumors - 30 (62.5%); acute and chronic gastric and duodenal ulcers - 16 (33.3%); erosive gastritis, esophagitis - 3 (6.25%). Primary inefficiency of endoscopic hemostasis was noted in 7 patients. In other 41 patients, endoscopic hemostasis was effective. Technical success rate was 100% (48 patients). Recurrence of bleeding was observed in 2 (4%) patients after 2 and 11 days. There was 1 complication (shoulder hematoma without necessary surgical correction). Mean hospital-stay was 15 days. Mortality rate was 33.3% (n=16); 32 (66.7%) patients were discharged.
CONCLUSION: Transcatheter arterial embolization is a quick, safe and effective minimally invasive alternative to surgery, when endoscopic treatment does not allow upper gastrointestinal bleeding control. The advantages of arterial embolization are feasibility of this method in high risk patients, combination of diagnostic angiography to identify the cause of bleeding, rapid hemostasis compared to other instrumental methods.