Burris Jennifer M, Lin Peter H, Johnston William F, Huynh Tam T, Kougias Panagiotis
Michael E DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Michael E DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, United States.
Am J Surg. 2009 Jul;198(1):59-63. doi: 10.1016/j.amjsurg.2008.07.046. Epub 2009 Jan 29.
Intractable nonvariceal upper gastrointestinal bleeding (UGIB) is associated with significant morbidity and mortality. Endovascular therapy is an alternative to surgery for high-risk patients.
Review of prospectively collected data from patients who underwent emergent gastroduodenal artery embolization for UGIB.
Eight patients (mean age 68.5 years) were identified. They all had significant comorbidities and were deemed to be at high risk for surgical intervention. Endoscopy was performed in 7 patients. Active extravasation was present at the time of embolization in 5 (62.5%) patients. The technical success and clinical response rates were each 100%. The 30-day mortality rate was 12.5%. [corrected] There were no procedure-related complications. During mean follow-up of 9 months, 1 patient developed recurrent bleeding that was managed conservatively.
Endovascular embolization is a safe alternative to open surgical intervention after failed endoscopic treatment for UGIB. Surgeons with endovascular skills can perform this procedure with superior results.
难治性非静脉曲张性上消化道出血（UGIB）与显著的发病率和死亡率相关。血管内治疗是高危患者手术治疗的替代方法。
回顾性分析前瞻性收集的因UGIB接受急诊胃十二指肠动脉栓塞术患者的数据。
共纳入8例患者（平均年龄68.5岁）。他们均伴有严重的合并症，被认为手术干预风险高。7例患者接受了内镜检查。5例（62.5%）患者在栓塞时存在活动性出血。技术成功率和临床有效率均为100%。30天死亡率为12.5%。[已校正]无手术相关并发症。在平均9个月的随访期间，1例患者出现复发性出血，经保守治疗。
对于内镜治疗失败的UGIB，血管内栓塞是开放手术干预的安全替代方法。具备血管内技术的外科医生实施该手术可获得更好的效果。
