The main reason why gastric bleeding requires surgical treatment is that the bleeding is severe and cannot be controlled by medication or other non-surgical methods. Treatment methods include endoscopic hemostasis, vascular embolization, and surgery, with the specific choice depending on the cause of bleeding and the severity of the condition.
1. Peptic ulcers are a common cause of gastric bleeding, especially when the ulcer erodes blood vessels, which can lead to massive bleeding. Endoscopic hemostasis is the preferred method, using electrocoagulation, injection of adrenaline, or clamping of blood vessels to directly stop the bleeding. If endoscopic treatment is ineffective, surgical removal of the ulcer or ligation of the bleeding vessels may be necessary.
2. Rupture of gastroesophageal varices is common in patients with cirrhosis, resulting in significant and difficult-to-control bleeding. Endoscopic ligation or sclerotherapy is a common method, but for severe cases, transjugular intrahepatic portosystemic shunt (TIPS) or surgical decompression may be necessary.
3. Bleeding caused by gastric cancer or submucosal tumors usually requires surgical removal of the tumor. Early-stage gastric cancer can be treated with endoscopic submucosal dissection (ESD), but advanced gastric cancer requires partial or total gastrectomy, along with dissection of surrounding lymph nodes.
4. Trauma or iatrogenic injury, such as accidental perforation during gastroscopy or tearing of the stomach wall due to trauma, requires emergency surgery to repair the damaged area and prevent further bleeding or infection.
5. Gastric bleeding caused by ruptured vascular malformations or aneurysms usually requires vascular embolization or surgical ligation of the abnormal blood vessels to completely stop the bleeding and prevent recurrence.
Surgery is usually required for cases of gastric bleeding that are considered critical. Patients should seek medical attention promptly. Doctors will select an appropriate treatment plan based on the specific cause and condition to control the bleeding as quickly as possible and reduce the risk of complications.