Retrospective multicenter analysis of the results of treatment for chronic duodenal ulcers complicated by bleeding

Introduction. Today, despite the therapeutic and diagnostic algorithms in the treatment of patients with ulcerative bleeding and the development of medical technologies, high postoperative and overall mortality remains amid a decrease in operational activity, which indicates the urgency of the problem and requires optimization of existing therapeutic and diagnostic algorithms.

The objective was to analyze the results of treatment of patients with chronic duodenal ulcers complicated by bleeding.

Methods and materials. A multicenter retrospective analysis of medical records of patients diagnosed with gastrointestinal bleeding was conducted in 4 hospitals in St. Petersburg for the period from 2018 to 2023. The sample included 379 patients with chronic duodenal ulcers complicated by bleeding. Such indicators as the size and localization of the ulcerative defect, J.A. J.A. Forrest type of bleeding, type of primary hemostasis, relapse rate, age, bed-day, mortality, presence of comorbid pathology, use of oral anticoagulants and antiplatelet agents were assessed.

Conclusions. A high mortality rate in patients with duodenal ulcers is associated with a high frequency of recurrent bleeding. The cause of relapse in some cases is inadequately performed endoscopic hemostasis. For chronic duodenal ulcers complicated by bleeding, combined endoscopic hemostasis with clipping of the bleeding vessel and subsequent drug therapy is indicated. The existing tactics in the treatment of ulcer bleeding are universal for ulcers of various diameters, however, as a retrospective analysis showed, a high percentage of recurrent bleeding and mortality is associated with bleeding from ulcers with a diameter of more than 2 cm, which determines the need to optimize treatment tactics specifically for ulcers of this ulcer diameter.

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