Клінічна хірургія (Oct 2020)

Endoscopic hemostasis in the ulcer gastro-duodenal hemorrhage, using high-frequency biological welding electro-ligature

  • Ya. P. Feleshtynskyi,
  • S. O. Oparin,
  • B. V. Sorokin,
  • M. G. Boiarska,
  • D. V. Lutsenko

DOI
https://doi.org/10.26779/2522-1396.2020.9-10.14
Journal volume & issue
Vol. 87, no. 9-10
pp. 14 – 17

Abstract

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Objective. To improve the efficacy of endoscopic hemostasis for the ulcer gastro-duodenal hemorrhage, using high-frequency biological welding electro-ligature. Materials and methods. In 2017-2020 yrs period the analysis of efficacy of endoscopic hemostasis was done in 160 patients, ageing 40-85 yrs old, for the ulcer gastro-duodenal hemorrhage. The patients were distributed into two groups: the main - 80 patients, in whom high-frequency biological welding electro-ligature was performed, and a control one - 80 patients, in whom monopolar thermal argon-plasm coagulation was conducted. Results. In the main Group a primary hemostasis was achieved in 77 (96.3%) patients. Early recurrence of hemorrhage have occurred in 3 (3.8%) patients. In a control Group a primary hemostasis was achieved in 66 (82.5%) patients. Recurrence of the hemorrhage have occurred in 14 (17.5%) patients. Conclusion. Endoscopic hemostasis for the ulcer gastro-duodenal hemorrhage, using high-frequency biological welding electro-ligature, is achieved due to the impedance action of modulated signal of a high-frequency current as well as the adaptive system of automatic guidance of the welding process and a contact between special endoscopic probe, owing a concave electrode, with bleeding vessel, leading to its complete obliteration. Application of welding electro-ligature for endoscopic hemostasis in the ulcer gastro-duodenal hemorrhage, using high-frequency biological welding electro-ligature, guarantees more secure residual hemostasis, than application of monopolar thermal argon-plasm coagulation, peculiarly in hemorrhage from vessels owing 2 - 4 mm diameter. As a result, the hemorrhage recurrence rate have had reduced down to 3.8% (in the control Group - 18.0%).

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