PMID- 36707418
OWN - NLM
STAT- MEDLINE
DCOM- 20230505
LR  - 20230510
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 37
IP  - 5
DP  - 2023 May
TI  - Clinical outcomes of marginal ulcer bleeding compared with those of peptic ulcer 
      bleeding.
PG  - 3852-3860
LID - 10.1007/s00464-023-09871-5 [doi]
AB  - BACKGROUND: Marginal ulcer bleeding (MUB) is a complication that can occur 
      following several types of surgery. However, few studies exist on it. Therefore, 
      this study aimed to compare the clinical outcomes of MUB with those of peptic 
      ulcer bleeding (PUB). METHODS: Between January 2013 and December 2017, 5,076 
      patients underwent emergent esophagogastroduodenoscopy for suspected upper 
      gastrointestinal bleeding. We retrospectively reviewed and analyzed the medical 
      records of MUB and PUB patients and developed a propensity score matching (PSM) 
      method to adjust for between-group differences in baseline characteristics with 
      1:2 ratios. Sex, age, body mass index (BMI), underlying diseases, and drugs were 
      included as matching factors. RESULTS: A total of 64 and 678 patients were 
      diagnosed with MUB and PUB, respectively, on emergent esophagogastroduodenoscopy, 
      and 62 and 124 patients with MUB and PUB, respectively, were selected after PSM. 
      Rebleeding was significantly higher in patients with MUB than in those with PUB 
      (57.8% vs 9.1%, p < 0.001). Mortality caused by bleeding was higher in patients 
      with MUB than in those with PUB (4.7% vs. 0.4%, p < 0.001). Multivariate analysis 
      revealed that proton pump inhibitor (PPI) administration (odds ratio [OR], 0.14; 
      95% confidence interval [CI], 0.03-0.56; p = 0.011) after first bleeding was 
      inversely correlated with MUB rebleeding. Large ulcer size (> 1 cm) (OR, 6.69; 
      95% CI, 1.95-27.94; p = 0.005) and surgery covering pancreas (OR, 3.97; 95% CI, 
      1.19-15.04) were independent risk factors for MUB rebleeding. CONCLUSIONS: MUB 
      showed a severe clinical course than PUB. Therefore, MUB should be managed more 
      cautiously, especially for large ulcers and pancreatic surgery. Prophylactic PPI 
      administration may be helpful in reducing rebleeding in MUB.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Seo, Jun-Young
AU  - Seo JY
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Noh, Jin Hee
AU  - Noh JH
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Ahn, Ji Yong
AU  - Ahn JY
AUID- ORCID: 0000-0002-0030-3744
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea. 
      ji110@hanmail.net.
FAU - Cho, Sang Yong
AU  - Cho SY
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Oh, Seung-Pyo
AU  - Oh SP
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Cha, Boram
AU  - Cha B
AD  - Digestive Disease Center, Department of Internal Medicine, Inha University School 
      of Medicine, Incheon, Korea.
FAU - Na, Hee Kyong
AU  - Na HK
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Lee, Jeong Hoon
AU  - Lee JH
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Jung, Kee Wook
AU  - Jung KW
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Kim, Do Hoon
AU  - Kim DH
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Choi, Kee Don
AU  - Choi KD
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Song, Ho June
AU  - Song HJ
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Lee, Gin Hyug
AU  - Lee GH
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
FAU - Jung, Hwoon-Yong
AU  - Jung HY
AD  - Department of Gastroenterology, Asan Medical Center, University of Ulsan College 
      of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
LA  - eng
PT  - Journal Article
DEP - 20230127
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - *Ulcer
MH  - Retrospective Studies
MH  - Peptic Ulcer Hemorrhage/etiology/surgery
MH  - *Peptic Ulcer
MH  - Gastrointestinal Hemorrhage/etiology/therapy
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Recurrence
OTO - NOTNLM
OT  - Anastomosis
OT  - Hemorrhage
OT  - Peptic ulcer
OT  - Proton pumps
OT  - Surgical
EDAT- 2023/01/28 06:00
MHDA- 2023/05/05 06:42
CRDT- 2023/01/27 23:12
PHST- 2022/08/22 00:00 [received]
PHST- 2023/01/04 00:00 [accepted]
PHST- 2023/05/05 06:42 [medline]
PHST- 2023/01/28 06:00 [pubmed]
PHST- 2023/01/27 23:12 [entrez]
AID - 10.1007/s00464-023-09871-5 [pii]
AID - 10.1007/s00464-023-09871-5 [doi]
PST - ppublish
SO  - Surg Endosc. 2023 May;37(5):3852-3860. doi: 10.1007/s00464-023-09871-5. Epub 2023 
      Jan 27.