1. Clinical treatment of gastroduodenal bleeding
- Author
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Hiroyoshi Mieno, Yoshiki Hiki, Yuzuru Sakakibara, and Hideto Tsukamoto
- Subjects
medicine.medical_specialty ,business.industry ,Mortality rate ,Gastroenterology ,Surgical mortality ,Hepatology ,Prognosis ,Colorectal surgery ,Surgery ,Peptic Ulcer Hemorrhage ,Japan ,Surgical oncology ,Hemostasis ,Internal medicine ,medicine ,Humans ,Emergencies ,business ,Gastrointestinal Hemorrhage ,Clinical treatment ,Abdominal surgery - Abstract
Our present study was conducted by cooperation between Departments of Internal Medicine and surgery of a hospital, which was highly significant because the results were comprehensive without a bias toward either department. The present report describes whether or not emergency operations have decreased because of progress in various conservative hemostatic methods for hemorrhagic ulcer and short-term and long-term prognoses after conservative therapy. Compared with the first 8-year period, the number of patients treated by conservative therapy increased with a definite decrease in that of emergency operations in the latter 8-year period. As for the results of conservative treatment, the rate of short-term prognostic hemostasis was 81.3%. Of the long-term prognostic cases, ulcers recurred in 50%, accompanied by recurrent bleeding in 34.8%. These patients were again treated by conservative therapy, and hemostasis was successful in 95.7%. The mortality rate following conservative therapy was 13.7% in the first period and 11.0% in the latter period. The surgical mortality rate was 6.0% in the first period and 5.4% in the latter period. There was no surgical death among the patients undergoing palliative operation. Our therapeutic policy for hemorrhagic ulcer will be described based on these findings.
- Published
- 1991