Role of erosive and ulcerative gastric lesions in the development of hemorrhagic complications in liver cirrhosis

Abstract

We present the results of the treatment of 135 patients with a hepatic form of portal hypertension (liver cirrhosis) that have been hospitalized in the clinic of the Department of Surgery No. 2 in Bogomolets National Medical University within the period from 2011 to 2020. The aim of our study was to reveal the factors of the 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 stomach lesions in portal hypertension is increased transcapillary filtration in the edematous-ascitic stage of liver cirrhosis. As a result, portal stagnation and reduced colloid mucus-bicarbonate barrier of the stomach led to the development of actual gastric ulcers. Erosive and ulcerative lesions on a 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 were complicated by gastric bleeding development. 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. Successful 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), and postoperative mortality was 25% (2 patients died).