A contribution to surgical treatment of gastric and duodenal ulcer hemorrhage in critically unstable patients

One of the complications of gastroduodenal ulcer disease is gastrointestinal hemorrhage; it is a cause of a substantial mortality. Standard therapy of gastroduodenal hemorrhage consists of endoscope sclerosation, over sewing or resection. The aim of this study is to analyze our results and methods in treatment of life threatening patients with gastroduodenal hemorrhage. A series of 47 life treating patients was surgically treated in General Hospital Sveti Duh in Zagreb for gastroduodenal hemorrhage during the period of 10 years and were retrospectively analyzed. Massive gastroduodenal hemorrhage was endoscopically confirmed, and after insufficient endoscopic therapy, surgically treated. For a treatment in 47 patients (which could not survive gastric resection) we used ulcer over sewing in 20 of them combined with gastroduodenal artery (GDA) or left gastric artery (LGA) ligation. Patients which were treated with combination of artery ligation and ulcer oversewing, had better results in stopping gastroduodenal hemorrhage, lower mortality and recidivism when they were compared with group which was treated only with standard ulcer oversewing, without artery ligations. Combination of artery ligation (LGA or GDA) and ulcer oversewing shows better results in stopping gastroduodenal hemorrhage than standard ulcer suture itself.