International Medical Journal, Vol. 25., Iss. 2, 2019, P. 18−22.
ENDOSCOPIC HEMOSTASIS IN BLEEDING FROM VARICOSE VEINS IN PATIENTS WITH PORTAL HYPERTENSION
Kharkiv National Medical University
SI "V. T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
The treatment results for the patients with portal hypertension, complicated by esophageal and gastric variceal bleeding, using endoscopic hemostasis methods, namely ligation and sclerotherapy, were analyzed. Endoscopic sclerotherapy was performed with ongoing bleeding, under conditions of stopped bleeding, some patients were introduced with probe obturator. In the groups of patients who received sclerotherapy, the persistent hemostatic effect was 86.2 %; recurrent bleeding with a favorable outcome did 9.2 %; total mortality made 6.1 %. Thus, the basis of successful treatment is a differentiated approach to the choice of the endoscopic hemostasis method. When choosing a treatment one should take into account the localization, extent of varices and the severity of the underlying disease. Endoscopic methods of hemostasis and prevention of complications are effective and should remain on the first line of treatment for these patients. The most optimal is the achievement of temporary hemostasis during drug therapy, balloon tamponade and correction of homeostasis functions, followed by the final choice of the method and endoscopic hemostasis in the delayed period.
Key words: bleeding, varicose veins, endoscopic sclerotherapy, endoscopic ligation.