Editorial: ulcer‐related vs non‐ulcer‐nonvariceal upper gastrointestinal bleeding—which has worse outcomes?

Yuan, Yuhong; Leontiadis, Grigorios I

doi:10.1111/apt.15144

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…In the western world, bleeding from peptic ulcers (PUs) is the most frequent cause of upper gastrointestinal bleeding. It is associated with high rates of morbidity, mortality, and healthcare expenses [9,10]. According to conventional wisdom, a hypersecretory acidic environment combined with dietary variables or stress is the cause of mucosal disruption in patients with acid peptic illness.…”

Section: Introductionmentioning

confidence: 99%

Peptic Ulcer Disease (PUD), Diagnosis, and Current Medication-Based Management Options: Schematic Overview

Srivastav,

Kumar,

Srivastava

et al. 2023

JAMPS

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A common condition in the world, Peptic Ulcer condition is sometimes referred to as stomach ulcers or peptic ulcers. PUD is caused by a defect in the mucosa of the stomach or duodenum that extends beyond the muscularis mucosa. PUD is the consequence of an imbalance between the aggressive and defensive elements impacting the mucosa, which occurs after gastric mucosal lesions. Peptic ulcer disease (PUD) is a widespread ailment affecting 5–10% of the world's population, with notable racial and regional variations. As a result of an imbalance between the aggressive and defensive elements impacting the mucosa, comes gastric mucosal injuries. The word "peptic" comes from the hormone pepsin, which is essential in causing mucosal breakdown. The most common cause of upper gastrointestinal bleeding in the Western world is bleeding from peptic ulcers (PUs). High rates of morbidity, mortality, and medical costs are linked to it. This review article covers the pathophysiology, aetiology, medical therapy, diagnosis, symptoms, and signs of Peptic Ulcer Disease (PUD).

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Section: Introductionmentioning

confidence: 99%

Peptic Ulcer Disease (PUD), Diagnosis, and Current Medication-Based Management Options: Schematic Overview

Srivastav,

Kumar,

Srivastava

et al. 2023

JAMPS

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“…Due to the significant incidence of gastroduodenal ulcers [1][2][3], surgical treatment of gastric and duodenal ulcers (DU) with a combination of complications [4,5] is extremely relevant. This is evidenced by the increase in the number of complications themselves [6,7] and by different views on the surgical tactics for their treatment [1,8,9].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of acute complicated duodenal ulcer

2022

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The aim. To analyze treatment approaches and tactics and improve acutely complicated duodenal ulcers (DU) treatment results. Materials and methods. The results of the analysis of the surgical treatment of acutely complicated duodenal ulcers (a combination of 3 and/or 4 combined complications) are presented for 2 periods: the 1st (2000–2014) years (group A) – 47 patients, the 2nd (2015–2021) years (group B) – 34 patients. Results. 81 (100 %) patients were operated on for acutely complicated duodenal ulcers, of which 68 (84.3 %) patients had a combination of three complications, and 13 (15.7 %) had four complications. Out of 81 patients, 72 had bleeding complications, which is 89.3 %. Complications of ulcer perforation – in 36 patients, 44.7 % of all other complications. Based on the obtained analysis data, there is a steady trend towards an increase in the share of organ-sparing operations (OSO) by 1.6 times (from 50.9 % to 81.4 %), a decrease in the number of gastric resections (GR) by 2.9 times (from 14.9 % to 4.9 %) and palliative operations (PO) by 3.2 times (from 15.8 % to 4.9 %) with a relatively stable number of performed organ-preserving operations (OPO): in group A – 17 (24 .6 %) interventions, in group B – 4 (21.1 %). Conclusions. The use of modern measures of endoscopic hemostasis made it possible to adequately prepare and operate on patients in the delayed period, and their share from the first period to the second increased by 2.9 times. The number of patients who underwent emergency surgery with ulcer perforation and bleeding as combined complications decreased in the second period compared to the first by 2.5 times, which is associated with the widespread use of modern proton pump inhibitors (PPIs) in the conservative treatment of DU. The number of complications and mortality of this cohort of patients also significantly decreased due to the use of endoscopic hemostasis methods, making it possible to stabilize and prepare patients on the operating table. According to the analysis results, it became known that the chosen active-individualized tactics and the use of developed algorithms for choosing the type of surgical intervention made it possible to achieve a stable level of postoperative mortality at 8.1 %.

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“…Despite the widespread introduction of new schemes of antiulcer and antihelicobacter therapy [1,2], surgical treatment of complicated duodenal ulcers (DU) remains an urgent problem today [2,4], which is associated with an increase in the number of complications and different views on the choice of surgical treatment [5][6][7]. Information on tactical approaches and results of surgical treatment of patients with a combination of complications such as bleeding (Bl) [8], perforation (P) [9], penetration (Pen), stenosis (St) in various combinations are rare in the available literature [10][11][12]. Despite the global trend of a slight decrease in the incidence of duodenal ulcer, there is, although insignificant, the number of patients with concomitant life-threatening combined complications [3,7].…”

Section: Introductionmentioning

confidence: 99%

Analysis of surgical treatment of duodenal ulcers with multiple combined complications

et al. 2021

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The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients. Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %). Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.

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Editorial: ulcer‐related vs non‐ulcer‐nonvariceal upper gastrointestinal bleeding—which has worse outcomes?

Abstract: Linked ContentThis article is linked to Sey et al paper. To view this article, visit https://doi.org/10.1111/apt.15092.

Cited by 6 publications

References 5 publications

Peptic Ulcer Disease (PUD), Diagnosis, and Current Medication-Based Management Options: Schematic Overview

Peptic Ulcer Disease (PUD), Diagnosis, and Current Medication-Based Management Options: Schematic Overview

Surgical treatment of acute complicated duodenal ulcer

Analysis of surgical treatment of duodenal ulcers with multiple combined complications

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