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

Jailani RF 1 , Kosai NR 1 , Yaacob NY 2 , Jarmin R 1 , Sutton P 3 , Harunarrashid H 4 Show all authors , Murie J 5 , Das S 6

Affiliations 

  • 1 Departments of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 2 Departments of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 3 Institute of Translational Medicine, University of Liverpool, UK
  • 4 Departments of 1Surgery, and 2Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 5 Department of Vascular Surgery, Edinburgh Royal Infirmary, UK
  • 6 Department of Anatomy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Clin Ter, 2014;165(6):294-8.
PMID: 25524184 DOI: 10.7417/CT.2014.1771

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.

CONCLUSIONS: TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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