Background: Peptic ulcer disease continues to be the most common cause of non-variceal upper gastrointestinal bleeding. The clinical presentation varies depending on the intensity of bleeding. It can range from an occult bleed to melena or hematemesis and haemorrhagic shock. The diagnostic procedure Esophagogastroduodenoscopy is gold standard for confirmation of peptic ulcer disease and is also helpful in identification of bleeding source. Irrespective of recent advances in medical treatment of peptic ulcer disease, it is important to quickly identify any signs and symptoms of bleeding. This allows for appropriate management of the bleed at an early stage. Therefore, it is important to know the frequency of peptic ulcer disease amongst upper GI bleeds. Aims and Objectives:The main aim of the current study is to identify the burden of peptic ulcer disease amongst patients with upper gastro-intestinal bleeding. Methodology: This retrospective study on 100 selected patients was conducted at the gastrointestinal unit, department of General Medicine, in a South Asian tertiary care centre, over a period of 6 months between May 2020 to December 2020.This period includes review of literature, collection and analysis of data, discussion and finalization of the report. 100 selected patients presenting to the outpatient department with GI symptoms and upper gastrointestinal bleeding, both male and female and above 18 years of age were enrolled in the study. The patient's medical history was recorded and diagnosis of peptic ulcer disease was confirmed by Esophagogastroduodenoscopy (EGD). Results: Out of 100 investigated cases of upper gastrointestinal bleeding, frequency of peptic ulcer disease was 53, of which 24 were duodenal ulcer, 21 were gastric ulcer,7 were with both gastric and duodenal ulcer and 1 was an esophageal ulcer. The age distribution in the study population ranged from 30 years to 90 years. With the youngest being 33 years of age and oldest 86years. The mean age was 55 years. Out of 100 cases 76 were males and 24 were females, giving a M: F ratio of 3:1.Risk factors included alcohol intake which was seen in 32 patients, smoking was seen in 41, and NSAID's use was seen in 8 patients; out of a total of 100 patients. Conclusion: Knowing the burden of peptic ulcer disease amongst upper gastrointestinal bleeds makes us aware of the morbidity it can cause. This makes us more alert and ensures mandatory evaluation for bleeding in any suspected or confirmed case of peptic ulcer disease.
techniques including use of intercostal trocars, Pringle maneuver, and semi-lateral position of patient were adapted. We also compared these patients with those who underwent open liver resection (OLR; n=124) for HCC in PS segments at the same period. Result: Mean operative time (395 minutes vs 331 minutes; P=0.013), intraoperative blood loss (1545 ml vs 1219 ml; P=0.020), and hospital stay (12 days vs 9, P<0.001) were significantly less in group 2. Postoperative complication rate (18.6% vs 18.9%; P=0.970), open conversion rate (23% vs 17%; P=0.374), 5-year overall survival (79% vs 89%; P=0.607) and 5-year disease free survival (52% vs 53%; P=0.657) rates were not significantly different between the groups. The proportion of LLR increased (36% vs 69%, P<0.001). Compared to OLR group, complication rate (40.3% vs 18.8%; P< 0.001) and hospital stay (18 days vs 10 days; P< 0.001) were significantly lower in LLR group. Conclusion:The complexity of LLR for HCC in PS segments has been gradually overcoming by the adaptation of advanced techniques.
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