Late outcome of undersewing alone for gastric ulcer haemorrhage

Abstract

Between 1977 and 1988 22 patients requiring urgent surgery for bleeding gastric ulceration were managed by simple undersewing of the ulcer. Long-term follow-up of these patients was undertaken to determine the risk of recurrent gastric ulceration and further gastric ulcer haemorrhage. Two patients died in the immediate perioperative period leaving 20 patients available for long-term follow-up (mean 43.3 months). Three recurrent gastric ulcers were diagnosed, two of these presenting with haemorrhage. No patient presented with further gastric ulceration while on histamine (H2) receptor antagonist therapy. The long-term outcome of undersewing alone, when combined with maintenance H2-receptor antagonist therapy, is satisfactory in terms of low mortality and low risk of ulcer recurrence.

Outcome and predictive factors of successful transarterial embolization for the treatment of acute gastrointestinal hemorrhage

“…Surgical management in GIB is associated with significant morbidity and mortality (4,6).The outcome of surgery in acute GIB is determined by knowledge of the bleeding point (7), type of operation (8), and general condition of the patient (9). If the bleeding source is unclear, particularly in a poor surgical candidate, the use of angiography has been advocated to identify and treat the source of bleeding (7,10).…”

Trends in Peptic Ulcer Bleeding and Surgical Treatment

“…Again, few data are available. In a series of 22 patients with gastric ulcer hemorrhage and undersewing of the ulcer and a mean follow-up period of 43 months, no patient on histamine (H 2 )-receptor antagonist therapy presented with further gastric ulcer bleeding, but two patients without this treatment did so [73]. An operation, if necessary, should no longer aim at curing the ulcer disease but primarily at stopping hemorrhage.…”