Gastroenterology and Digestive Endoscopy Unit Ospedale Morgagni-Pierantoni, Forlì-Ospedale M. Bufalini, Cesena-AUSL, 47521 Romagna, Italy.
Department of Surgery, Oncology and Gastroenterology (DISCOG), University Hospital of Padua, 35128 Padua, Italy.
Medicina (Kaunas). 2023 Nov 2;59(11):1941. doi: 10.3390/medicina59111941.
Postoperative non variceal upper gastrointestinal haemorrhage may occur early or late and affect a variable percentage of patients-up to about 2%. Most cases of intraluminal bleeding are an indication for urgent Esophagogastroduodenoscopy (EGD) and require endoscopic haemostatic treatment. In addition to the approach usually adopted in non-variceal upper haemorrhages, these cases may be burdened with difficulties in terms of anastomotic tissue, angled positions, and the risk of further complications. There is also extreme variability related to the type of surgery performed, in the context of oncological disease or bariatric surgery. At the same time, the world of haemostatic devices available in digestive endoscopy is increasing, meeting high efficacy rates and attempting to treat even the most complex cases. Our narrative review summarises the current evidence in terms of different approaches to endoscopic haemostasis in upper bleeding in altered anatomy after surgery, proposing an up-to-date guidance for endoscopic clinicians and at the same time, highlighting areas of future scientific research.
术后非静脉曲张性上消化道出血可发生在早期或晚期，影响一定比例的患者，高达约 2%。大多数腔内出血的病例都需要紧急进行食管胃十二指肠镜检查（EGD），并需要内镜止血治疗。除了非静脉曲张性上消化道出血通常采用的方法外，这些病例可能在吻合组织、角度位置以及进一步并发症的风险方面存在困难。在肿瘤疾病或减重手术的背景下，手术类型也存在极大的变异性。与此同时，消化内镜中可用的止血设备种类也在不断增加，以实现高疗效，并尝试治疗即使是最复杂的病例。我们的叙述性综述总结了目前在手术后解剖结构改变的上消化道出血内镜止血的不同方法方面的证据，为内镜临床医生提供了最新的指导，同时还突出了未来科学研究的领域。
