{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:05:05Z","timestamp":1760954705730},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[1995,1,1]],"date-time":"1995-01-01T00:00:00Z","timestamp":788918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Therapeutic endoscopy (TE) has provided a new means for treating peptic ulcer disease, prompting a reevaluation of surgery's role. The aim of this study was to determine if surgical therapy of bleeding duodenal ulcers has changed since the advent of TE. This retrospective review involved consecutive time periods during which TE was (1985\u20131990) and was not (1980\u20131984) widely available. Exclusion criteria were prior gastric surgery, nonpeptic conditions, and untreated ulcers. Inclusion standards were met by 252 patients (180\u00a0men, 72 women) whose mean age was 67 years. Patients were grouped by the initial therapeutic intervention. Groups were similar in age, medical condition (mean APACHE II score 16), and morbidity. Seventy\u2010five patients had surgery alone during 1980\u20131984 and 38 during 1985\u20131990. TE was initially performed on 134 patients during 1985\u20131990. Bleeding (<jats:italic>n<\/jats:italic>=30) and perforation (<jats:italic>n<\/jats:italic>=1) prompted emergent operation in 23% of cases following TE. Thus 69 (38+31) patients underwent surgery between 1985 and 1990. Preprocedure transfusions averaged 4.1 units in the endoscopic group and 8.2 units in the operative groups (<jats:italic>p<\/jats:italic>&lt;0.0001). Disagreement existed between the endoscopic and surgical descriptions of ulcer location in 53% of cases. Emergent surgery was required in 45% of hemodynamically unstable patients versus 14% of stable patients who initially underwent TE (<jats:italic>p<\/jats:italic>&lt;0.0001). Sixty\u2010one percent of incompletely visualized TE\u2010treated lesions required operation, and 18% of well visualized ulcers underwent operation (<jats:italic>p<\/jats:italic>&lt;0.0001). Hospital mortality was similar (8% versus 16%) in the endoscopic and operated groups (<jats:italic>p<\/jats:italic>=0.7). Mean follow\u2010up was 540\u00a0days. The number of operations performed for bleeding duodenal ulcer did not change significantly during the TE era, and a significant subset (23%) of endoscopically treated patients required surgical therapy. TE failure was portended by hemodynamic instability or incomplete endoscopic visualization.<\/jats:p>","DOI":"10.1007\/bf00316985","type":"journal-article","created":{"date-parts":[[2004,12,10]],"date-time":"2004-12-10T04:25:59Z","timestamp":1102652759000},"page":"89-94","source":"Crossref","is-referenced-by-count":6,"title":["Impact of therapeutic endoscopy on the treatment of bleeding duodenal ulcers: 1980\u20131990"],"prefix":"10.1002","volume":"19","author":[{"given":"Alexander R.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Surgery Mayo Clinic 55905 Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Farnell","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 55905 Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith A.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 85259 Scottsdale Arizona U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Gostout","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Mayo Clinic 55905 Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne T.","family":"Benson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Mayo Clinic 55905 Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1995,1]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6426.1277"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800740910"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)91803-8"},{"key":"e_1_2_1_5_1","first-page":"307","article-title":"Surgical management of gastroduodenal hemorrhage","volume":"143","author":"Heideman M.","year":"1977","journal-title":"Acta Chir. 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Belg."},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198401000-00008"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(85)80081-0"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03430100103037"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.286.6362.345"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.291.6490.245"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800760606"},{"issue":"632","key":"e_1_2_1_24_1","article-title":"Does ulcer position influence presentation or prognosis of acute gastrointestinal bleeding [abstract]?","volume":"27","author":"Swain C.P.","year":"1986","journal-title":"Gut"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1010616"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197906213002503"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199004000-00006"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01658105"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/BF00316985.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/BF00316985\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/BF00316985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T15:34:21Z","timestamp":1703691261000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/BF00316985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,1]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1995,1]]}},"alternative-id":["10.1007\/BF00316985"],"URL":"https:\/\/doi.org\/10.1007\/bf00316985","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,1]]}}}