ACUTE GASTRODUODENAL BLEEDING ULCER: FEATURES OF MODERN TREATMENT STRAEGY

The aim of the study: to analyze the treatment results in patients with acute gastroduodenal bleeding ulcer to check the optimization possibilities. Materials and methods. We have analyzed results of the treatment of 8893 patients with acute upper non-variceal gastrointestinal bleedings from 2001 to 2017 in the clinic of the department of surgery end endoscopy. Bleeding peptic ulcer was diagnosed in 4173 (46,9%) patients. Results.Early esophagogastroduodenoscopy was per-formed in all patients, it took the main role for bleeding site diagnosis and became an initially treatment option (928 patients – 22,2%), which allowed to stop bleeding in 226 (24,3%) and to reduce re-bleeding risk in 702 (75,7%) patients. Bleeding recur-rence occurred in 212 (5,1%) patients, from which in 108 – after endoscopic hemostasis; it was 11,6% of all endoscopically treated patients. According international recommendations in majority of patients were used recurrent attempts of endoscopic hemostasis, which were effective in 94 (44,3%) cases. When it was ineffective, we performed urgent surgery (112 patients – 52,8%). The usage of endoscopic hemostatic methods with an-tisecretory medication is the main strategy of treatment. The bleeding recurrence in case of endoscopic hemostasis failure in patients with high operative risk is the main problem in treatment of this pathology.