Control Of Proximal Gastric Bleeding: Combined Laparoscopic and Endoscopic Approach

Mixter, Charles G.; Sullivan, Cornelius A.

doi:10.1089/lps.1992.2.105

Cited by 21 publications

(6 citation statements)

References 7 publications

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“…The area was marked by clips or suture laparoscopically and resection was then performed. 34 Mixter et al 40 described the use of combined endoscopy and laparoscopy to identify and ligate the artery that feeds the bleeding Dieulafoy's lesion without the need for resection.…”

Section: Role Of Minimally Invasive Surgerymentioning

confidence: 99%

“…36 However, wedge resection may not be feasible for lesions situated within 6 cm of the gastrooesophageal junction; in these circumstances, oversewing the lesion or laparoscopic clip placement on the vessel feeding the lesion may be a better option. 36,40 Alva et al 34 described pre-operative localisation of the lesion by both tattooing with India ink and using clips, thus allowing accurate localisation whilst alleviating the need for intra-operative endoscopy. The most frequent difficulty with clip placement is that it could fall out prior to surgical intervention.…”

Section: Role Of Minimally Invasive Surgerymentioning

confidence: 99%

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Dieulafoy's lesion: current trends in diagnosis and management

Baxter

Aly

2010

annals

288

372

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Ann R Coll Surg Engl 2010; 92: 548-554 548The incidence of acute gastrointestinal bleeding ranges from 50-150 per 100,000 of the population each year. It is caused by peptic ulcers and oesophageal or gastroduodenal erosions in almost 80% of patients.1 Obscure gastrointestinal bleeding is reported to account for up to 5% of all gastrointestinal (GI) haemorrhages. It is defined as overt or occult bleeding from a source that cannot be readily determined by standard investigations, such as barium studies and endoscopic investigation. The source is often difficult to locate because the pathology is anatomically inaccessible, small, or subtle. Dieulafoy's lesion is one of the causes of obscure gastrointestinal bleeding that could result in treacherous and life-threatening gastrointestinal haemorrhage. 2,3A Dieulafoy's lesion, also termed 'calibre persistent artery', 2 is a relatively rare, but potentially life-threatening, cause of haemorrhage from the gastrointestinal tract. It is difficult to determine its true incidence in the general population accurately as they are silent until presentation and, even then, it can pose a diagnostic challenge. They are believed to account for only 1-2% of acute GI bleeding, [3][4][5] but are arguably under-recognised rather than being truly rare. The lack of awareness about the Dieulafoy's lesion contributes to its 'rarity', increase in morbidity, and also the previously reported mortality of up to 80% associated with this lesion.6 Rare or not, the precarious nature of the presentation make it necessary to include them in differential diagnosis of any acute GI haemorrhage. The aim of this article is to present an up-to-date review of literature on Dieulafoy's lesion and the recent trends in its diagnosis, treatment and prognosis. Materials and MethodsUsing Medline, a literature search was performed for papers published in English, using the text words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers which were relevant to the study were analysed and the findings are summarised in this review. Overall, 159 Dieulafoy's lesion: current trends in diagnosis and management M Baxter, EH AlyLaparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary, Aberdeen, UK ABSTRACT BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control t...

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Section: Role Of Minimally Invasive Surgerymentioning

confidence: 99%

Section: Role Of Minimally Invasive Surgerymentioning

confidence: 99%

Dieulafoy's lesion: current trends in diagnosis and management

Baxter

Aly

2010

annals

288

372

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“…Another option for hemostatic control is suture ligation or wedge resection after location by double transillumination using simultaneous endoscopy and laparoscopy [37]. With endo-organ surgery, the bleeding vessel can be sutured under direct vision.…”

Section: Dieulafoy's Lesionmentioning

confidence: 99%

Indications for endo-organ gastric excision

Mittal

Filipi

2000

Surg Endosc

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Intragastric surgery for benign and malignant conditions is a new form of minimally invasive surgery, to which the term endo-organ gastric surgery has been applied. This procedure may provide improved results for patients, but reported studies are small, and follow-up evaluation is limited. The indications for endo-organ surgery are evolving as technology and operative expertise begin to meet the need for continued advancements in miniaturized surgery. This new approach is applied primarily to the removal of gastric neoplasms poorly positioned or too large for standard transoral endoscopic excision. Gastric polyps, benign gastric wall tumors such as leiomyomas and carcinoids, and low-grade as well as high-grade malignancies can be removed. The history of endo-organ surgery, the background technology, and surgical experience are reviewed. In addition, current indications for endo-organ surgery and the rationale for algorithms are included. Intraluminal gastric surgery is not widely performed or studied, therefore a further understanding of its role is provided.

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“…Surgical treatment options include gastric wedge resection, ligation of the feeding vessels, simple over sewing of the lesion (all of which have been described laparoscopically), 14 –16 and gastrectomy with and without vagotomy and pyloroplasty 17 . The combination of intra‐operative endoscopy with laparoscopic surgery has also been described, employing vessel ligation and/or over sewing, or wedge resection.…”

Section: Introductionmentioning

confidence: 99%