THE ROLE OF EROSIVE AND ULCERATIVE GASTRIC LESIONS IN THE DEVELOPMENT OF HEMORRHAGIC COMPLICATIONS IN LIVER CIRRHOSIS

Abstract

There were studied the results of treatment of 135 patients with hepatic form of portal hypertension (liver cirrhosis), hospitalized in the clinic of the Department of Surgery №2 of the Bogomolets National Medical University in the period from 2011 to 2020. The aim of the study was to study the factors of development of erosive and ulcerative gastric lesions in liver cirrhosis and their role in the occurrence of hemorrhagic complications. Based on studies of the rheological properties of gastric mucus, it was found that one of the leading factors in the development of erosive and ulcerative lesions in the stomach in portal hypertension is increased transcapillary filtration in edematous-ascitic stage of liver cirrhosis, which due to portal stagnation and reduced colloid muco-bicarbonate barrier of the stomach and causes the development of actual gastric ulcers. Erosive and ulcerative lesions on the part of the gastric mucosa were found in 66 (48.9%) of patients with cirrhosis of the liver, and in 45.2% of cases (28 persons) they are complicated by the development of gastric bleeding. Pathogenetic treatment of gastric ulcer-erosive bleeding in portal hypertension, against the background of the use of endoscopic hemostasis, should be aimed at strengthening the protective properties of the mucous-bicarbonate barrier of the stomach. Good results of surgical treatment were achieved in 64.3% of patients. The overall mortality in liver cirrhosis complicated by gastric bleeding from ulcerative lesions of the stomach was 21.4% (6 patients died), postoperative mortality was 25% (2 patients died).