Modern Trends in Endoscopic Hemostasis in Patients With Erosive-Ulcerative Gastrointestinal Bleeding With Prerogative Use of Argon Plasma Coagulation and Taking Into Account the Special Conditions of the Endoscopy Department in Wartime

Abstract

Abstract. The article presents the peculiarities of the functioning of the endoscopy department during active hostilities and martial law, highlighting the progressive methods of minimally invasive endoscopic hemostasis in patients with erosive-ulcerative gastrointestinal bleeding based on the prerogative use of argon plasma coagulation. Objective. To study the effectiveness of endoscopic hemostasis in erosive-ulcerative bleeding with the prerogative use of argon plasma coagulation in special wartime conditions. Research Methods and Discussion. The research was conducted on the basis of 17638 endoscopic examinations performed at the GI «V.T. Zaycev Institute of General and Urgent Surgery of NAMS of Ukraine» during active hostilities and martial law. Acute gastrointestinal bleeding was diagnosed in 1083 patients, 38.97% of whom had ulcerative gastric and duodenal injuries. The advantages of combined endoscopic hemostasis used in 661 cases of erosive-ulcerative bleeding, performed on a modern digital video endoscopic complex and the prerogative use of argon plasma coagulation as a basic in combination with other minimally invasive technologies, were evaluated. Conclusions: In martial law conditions, the use of combined endoscopic hemostasis with the basic use of AP-coagulation allows to achieve primary local hemostasis in 98.77 % of ongoing erosive-ulcerative bleeding. Recurrence of bleeding in this category of patients is a justification for repeated endoscopic, and in case of its ineffectiveness – urgent X-ray surgical or open surgical intervention.