Our surgery experience of non-oesophageal varices upper gastrointestinal bleeding

Abstract

Necessity for surgery in the treatment Acute Upper Gastrointestinal Bleeding (AUGIB) is gradually decreasing. In spite of the decrease in the need for surgery, there is no decrease in rates of mortality and complication following surgery. The aim of this study is to present outcomes of the patients operated on AUGIB. Files of the patients operated on AUGIB, from 1 January 2010 to 2020, were examined. Age, gender and diagnosis of the patients, conservative treatment methods prior to surgery, surgery, duration of hospital stay, rates of mortality and complications were retrospective analyzed. 15 patients with UGH diagnosis were involved in the study. Out of 15, 12 male and 3 female, and their mean age was 61.26 (22-88). All the patients received endoscopic examination before the surgery. 2 patients received total gastrectomy, 1 distal gastrectomy, 3 gastrostomy and haemorrhage control, 6 HM pyloroplasty and bilateral truncal vagatomy, 2 HM pyloroplasty + gastrojejunostomy and bilateral truncal vagatomy, and 1 Whipple surgery. Average hospital stay was 10.53 (1-19) days. Mortality rate was 33%, complication was 26%. Surgical need for AUGIB was decreased by 2% over the years. Despite decrease in the need of surgery, rates of mortality and complication were 30% and 55% respectively. Mortality is generally caused by co-morbid disease.

Keywords

• upper gastrointestinal
• bleeding
• surgery
• Outcomes

References

1. Bulut, O., Rasmussen, C., Fischer, A., 1996. Acute surgical treatment of complicated peptic ulcers with special reference to the elderly. World journal of surgery. 20, 574-577.
2. Clarke, M., et al., 2010. The surgical management of acute upper gastrointestinal bleeding: a 12-year experience. International Journal of Surgery. 8, 377-380.
3. Feinman, M., Haut, E.R., 2014. Upper gastrointestinal bleeding. Surg Clin North Am. 94, 43-53.
4. Greenspoon, J., et al., 2012. Management of patients with nonvariceal upper gastrointestinal bleeding. Clinical Gastroenterology and Hepatology. 10, 234-239.
5. Gutierrez, G., Reines, H., Wulf-Gutierrez, M.E., 2004. Clinical review: hemorrhagic shock. Critical care. 8, 1-9.
6. Kamboj, A.K., Hoversten, P., Leggett, C.L., 2019. Upper gastrointestinal bleeding: etiologies and management. In: Mayo Clinic Proceedings. Vol. 94, ed.^eds. Elsevier, pp. 697-703.
7. Lanas, A., et al., 2005. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal antiinflammatory drug use. American Journal of Gastroenterology. 100, 1685-1693.
8. Loffroy, R., et al., 2010. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovascular and interventional radiology. 33, 1088-1100.

9. Longstreth, G.F., 1995. Epidemiology of Hospitalization for Acute Upper Gastrointestinal Hemorrhage: A Population--Based Study. American Journal of Gastroenterology. 90.
10. Rockey, D.C., Feldman, M., Travis, A., 2017. Causes of upper gastrointestinal bleeding in adults.
11. Srygley, F.D., et al., 2012. Does this patient have a severe upper gastrointestinal bleed? Jama. 307, 1072-1079.
12. TIRNAKSIZ, M.B., YORGANCI, K., 2005. Gastrointestinal Kanamanın Cerrahi Yönetimi.
13. Wuerth, B., Rockey, D., 2018. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Digestive diseases and sciences. 63, 1286