Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding

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Abstract

Background and Objective. To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract. Materials and Methods. A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed. Results. Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE. Conclusion. TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

Original languageEnglish
Pages (from-to)294-298
Number of pages5
JournalClinica Terapeutica
Volume165
Issue number6
DOIs
Publication statusPublished - 2014

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Hemorrhage
Therapeutics
Angiography
Upper Gastrointestinal Tract
Gastrointestinal Hemorrhage
Length of Stay
Mortality

Keywords

  • Angioembolization
  • Embolization
  • Surgery
  • Transarterial
  • Transcatheter

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{46e6676f0fb1421fa46125cb186d0c07,
title = "Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding",
abstract = "Background and Objective. To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract. Materials and Methods. A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed. Results. Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33{\%}) in the TAE group and 6 patients (28.6{\%}) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81{\%} vs 62.5{\%}, p = 0.17), 30-day mortality (33{\%} vs 29.1{\%}, p = 0.17) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE. Conclusion. TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.",
keywords = "Angioembolization, Embolization, Surgery, Transarterial, Transcatheter",
author = "Jailani, {R. F.} and {Nik Mahmood}, {Nik Ritza Kosai} and Yaacob, {Nur Yazmin} and Razman Jarmin and P. Sutton and {Haruna Rashid}, Hanafiah and J. Murie and Srijit Das",
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T1 - Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding

AU - Jailani, R. F.

AU - Nik Mahmood, Nik Ritza Kosai

AU - Yaacob, Nur Yazmin

AU - Jarmin, Razman

AU - Sutton, P.

AU - Haruna Rashid, Hanafiah

AU - Murie, J.

AU - Das, Srijit

PY - 2014

Y1 - 2014

N2 - Background and Objective. To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract. Materials and Methods. A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed. Results. Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE. Conclusion. TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

AB - Background and Objective. To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract. Materials and Methods. A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed. Results. Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE. Conclusion. TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

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KW - Embolization

KW - Surgery

KW - Transarterial

KW - Transcatheter

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