Choosing the optimal surgical method for duodenal ulcer complicated by bleeding

Genrikh S.R.; Durleshter V.M.; Kalachev A.G.; Bedanokov K.M.

doi:https://doi.org/10.17116/hirurgia2025021111

Genrikh S.R.

Regional Clinical Hospital No. 2

Durleshter V.M.

Regional Clinical Hospital No. 2

ORCID: 0000-0003-2885-7674

Kalachev A.G.

Regional Clinical Hospital No. 2

ORCID: 0000-0001-8476-5905

Bedanokov K.M.

Regional Clinical Hospital No. 2

ORCID: 0009-0003-8818-2610

Choosing the optimal surgical method for duodenal ulcer complicated by bleeding

Authors:

Genrikh S.R., Durleshter V.M., Kalachev A.G., Bedanokov K.M.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(2): 111‑118

DOI: 10.17116/hirurgia2025021111

Read: 1064 times

Contact the author

Table of contents

To cite this article:

Genrikh SR, Durleshter VM, Kalachev AG, Bedanokov KM. Choosing the optimal surgical method for duodenal ulcer complicated by bleeding. Pirogov Russian Journal of Surgery. 2025;(2):111‑118. (In Russ.)
https://doi.org/10.17116/hirurgia2025021111

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Recommended articles:

Preventive mesh replacement for postoperative ventral hernia. Pirogov Russian Journal of Surgery. 2025;(12):80-84

Pre-emptive embolization of inferior mesenteric and lumbar arteries in endovascular abdominal aortic aneurysm repair. Pirogov Russian Journal of Surgery. 2025;(11-2):5-11

Cost-effectiveness analysis of bariatric surgery in obese patients. Medical Technologies. Assessment and Choice. 2025;(1):62-75

Endoscopic technologies for the treatment of postoperative complications in bariatric patients. Endoscopic Surgery. 2025;(4):61-67

Laparoscopic access in the treatment of diseases of the reproductive system in patients with morbid obesity. Russian Journal of Human Reproduction. 2025;(4):102-109

Abstract:

The treatment tactics for gastrointestinal bleeding (GIB), recommended by surgical societies, involve a certain sequence of actions taking into account the capabilities of the clinical institution. A mandatory requirement for all levels of care is the stabilization of post-hemorrhagic disorders and stopping bleeding by any available means. A mandatory requirement for all levels of care is the stabilization of post-hemorrhagic disorders and stopping bleeding by any available means. A clinical case of treatment of a patient with duodenal ulcer complicated by recurrent bleeding is presented. Taking into account morbid obesity, the indications for the endoscopic method of stopping recurrent bleeding against the background of adequate replacement therapy have been expanded. An analysis of the selected treatment tactics for complicated peptic ulcer was carried out.

Keywords:

symptomatic ulcer

active bleeding

prognosis scale

morbid obesity

endoscopic monitoring

embolization

duodenoplasty

Authors:

Genrikh S.R.

Regional Clinical Hospital No. 2

Durleshter V.M.

Regional Clinical Hospital No. 2

ORCID: 0000-0003-2885-7674

Kalachev A.G.

Regional Clinical Hospital No. 2

ORCID: 0000-0001-8476-5905

Bedanokov K.M.

Regional Clinical Hospital No. 2

ORCID: 0009-0003-8818-2610

Received:

02.04.2024

Accepted:

26.09.2024

Close metadata

References:

Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F, Leontiadis GI, Abraham NS, Calvet X, Chan FKL, Douketis J, Enns R, Gralnek IM, Jairath V, Jensen D, Lau J, Lip GYH, Loffroy R, Maluf-Filho F, Meltzer AC, Reddy N, Saltzman JR, Marshall JK, Bardou M. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Annals of Internal Medicine. 2019;171(11):805-822. https://doi.org/10.7326/M19-1795
Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber DG, Abu-Zidan FM, Campanile FC, Di Saverio S, Baiocchi GL, Casella C, Kelly MD, Kirkpatrick AW, Leppaniemi A, Moore EE, Peitzman A, Fraga GP, Ceresoli M, Maier RV, Wani I, Pattonieri V, Perrone G, Velmahos G, Sugrue M, Sartelli M, Kluger Y, Catena F. Perforated and bleeding peptic ulcer: WSES guidelines. World Journal of Emergency Surgery. 2020;15:3. https://doi.org/10.1186/s13017-019-0283-9
Sung JJ, Chiu PW, Chan FKL, Lau JY, Goh KL, Ho LH, Jung HY, Sollano JD, Gotoda T, Reddy N, Singh R, Sugano K, Wu KC, Wu CY, Bjorkman DJ, Jensen DM, Kuipers EJ, Lanas A. Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018. Gut. 2018;67(10):1757-1768. https://doi.org/10.1136/gutjnl-2018-316276
Jiang M, Chen P, Gao Q. Systematic Review and Net-Work Meta-Analysis of Upper Gastrointestinal Hemorrhage Interventions. Cellular Physiology and Biochemistry. 2016;39(6):2477-2491. https://doi.org/10.1159/000452515
Lebedev NV, Klimov AE, Petukhov VA. Repeated endoscopic hemostasis as an alternative to surgical treatment of patients with gastroduodenal ulcerative bleeding. Pirogov Russian Journal of Surgery. 2016;(6):52-56. (In Russ.).
Kubyshkin VA, Petrov DIu, Smirnov AV. Endoscopic hemostasis in the treatment of the gastroduodenal ulcer bleeding. Pirogov Russian Journal of Surgery. 2013;(9):67-72. (In Russ.)
Beggs AD, Dilworth MP, Powell SL, Atherton H, Griffiths EA. A systematic review of transarterial embolization versus emergency surgery in treatment of major nonvariceal upper gastrointestinal bleeding. Clinical and Experimental Gastroenterology. 2014;7:93-104. https://doi.org/10.2147/CEG.S56725
Darmon I, Rebibo L, Diouf M, Chivot C, Riault C, Yzet T, Le Mouel JP, Regimbeau JM. Management of bleeding peptic duodenal ulcer refractory to endoscopic treatment: surgery or transcatheter arterial embolization as first-line therapy? A retrospective single-center study and systematic review. European Journal of Trauma and Emergency Surgery. 2020;46(5):1025-1035. https://doi.org/10.1007/s00068-020-01356-7
Grinberg AA, Zatevakhin II, Shchegolev AA. Khirurgicheskaya taktika pri yazvennykh gastroduodenal’nykh krovotecheniyakh. M.: Meditsina; 1996. (In Russ.).
American College of Surgeons Committee on Trauma. ATLS® Student Manual 10th Edition. Chicago: American College of Surgeons; 2018.
Coxib and traditional NSAID Trialists’ (CNT) Collaboration; Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, FitzGerald GA, Goss P, Halls H, Hawk E, Hawkey C, Hennekens C, Hochberg M, Holland LE, Kearney PM, Laine L, Lanas A, Lance P, Laupacis A, Oates J, Patrono C, Schnitzer TJ, Solomon S, Tugwell P, Wilson K, Wittes J, Baigent C. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382(9894):769-779. https://doi.org/10.1016/S0140-6736(13)60900-9
Castellsague J, Riera-Guardia N, Calingaert B, Varas-Lorenzo C, Fourrier-Reglat A, Nicotra F, Sturkenboom M, Perez-Gutthann S; Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Safety. 2012;35(12):1127-1146. https://doi.org/10.2165/11633470-000000000-00000
Bang CS, Joo MK, Kim BW, Kim JS, Park CH, Ahn JY, Lee JH, Lee BE, Yang HJ, Cho YK, Park JM, Kim BJ, Jung HK; Korean College of Helicobacter and Upper Gastrointestinal Research. The Role of Acid Suppressants in the Prevention of Anticoagulant-Related Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis. Gut Liver. 2020;14(1):57-66. https://doi.org/10.5009/gnl19009
Di Minno MN, Ambrosino P, Di Minno A, Tremoli E, Di Minno G. The risk of gastrointestinal bleeding in patients receiving dabigatran etexilate: a systematic review and meta-analysis of the literature. Annals of Medicine. 2017;49(4):329-342. https://doi.org/10.1080/07853890.2016.1268710
Kubyshkin VA, Sazhin VP, Fedorov AV, Krivtsov GA, Sazhin IV. Organization and results of surgical care for ulcerative gastroduodenal bleeding in the hospitals of Central Federal District. Pirogov Russian Journal of Surgery. 2017;(2):4-9. (In Russ.). https://doi.org/10.17116/hirurgia201724-9
Stupin VA, Baglaenko MV, Kan VI, et al. Lethality after gastroduodenal ulcer bleeding. Pirogov Russian Journal of Surgery. 2013;(5):31-35. (In Russ.).
Brekhov EI, Repin IG, Kalinnikov VV, Repin DI, Timoshkin SP. The role of the rockall and Glasgow—Blatchford scales in prediction of recurrent upper gastrointestinal bleeding. Russian Journal of Evidence-Based Gastroenterology. 2019;8(3):20-26. (In Russ.) https://doi.org/10.17116/dokgastro2019803120
Hunt R, Barkun An, Bardou M, Kuipers EJ, Sung J, Agreus L, Armstrong D, Calvet X, Chiba N, Cipolletta L, Cohen H, Enns R, Ericsson LG, Gralnek I, Jensen D, Kaminishi M, Kanwal F, Laine L, Lanas A, Lau J, Leontiadis G, Lundell L, Malfertheiner P, Marshall J, Martin J, Metz D, Moayyedi P, Quenot JP, Rauws E, Romagnuolo J, Rostom A, Spiegel B, Tse F, Van Leerdam M, Van Rensburg C, Jones DJ, Gardeazabal A, Rácz I, Lavigne P, Sinclair P. International consensus upper gastrointestinal bleeding conference group. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Annals of Internal Medicine. 2010;152:101-113. https://doi.org/10.7326/0003-4819-152-2-201001190-00009