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Innovative technologies in the surgical treatment of acute gastrointestinal bleedings



Kovalchuk l.Ya.,Shepetko Ye.M., Ivaschuk O.I., Shaprynsky V.O., Nikishayev V.I., Dzyubanovsky  I.Ya., Hrubnik Yu.V., Shulyarenko V.A., Ganji V.V., Rachkevych S.L.


Submitted by the Ternopol State Medical University named after I.Y.Gorbachevsky

Work is devoted to the development and widespread adoption of a new unique treatment guide of acute gastrointestinal bleedings with the priority use of innovative methods of laparoscopic and endoscopic hemostasis in conjunction with the use of modern proton pump inhibitors, and organ-preserving surgery.

Developed new and enhanced existing surgical, videoendoscopic and laparoscopic techniques of hemostasis, the method of selective embolization of bleeding from esophageal phlebectasis, endoscopic local gastric immune therapyfollowed by introduction in the routine healthcare practice.

Authors elucidated the dynamics of regional blood flow of gastroduodenal mucosa, morphological and immunomorphological changes of ulcer areas and their role in the pathogenesis of ulcerative and non-ulcerative bleeding, which allowed authors to modify existing organ-preserving and develop new organ-respecting pyloro-antrum-preserving gastric surgeries using the developed original equipment, laser technology, electrical suturing devices, ultrasonic scalpel, hematopoietic stem cells.

Use of innovative technologies in the treatment of 49,400 patients with acute gastrointestinal bleeding in the specialized centers of gastrointestinal bleeding in Ukraine helped to reduce the number of early recurrence of bleeding in 2.3 times, 2.1 times increase in number of organ-preserving, and 2.2 times increase in number of organ-respecting operations, reduce overall mortality in gastroduodenal ulcer bleeding was 2.8 times, postoperative mortality reduction in 4.2 times, total mortality in acute gastrointestinal bleeding - 2.2 times reduction.

Publications: 400, including 20 monographs, 8 guidelines of Health Ministry of Ukraine, 372 articles. Received 91 patents for inventions of Ukraine. On this subject 3 doctoral and 22 master's theses protected.