Micheline kim boston scientific

Share this article Share with email Share with twitter Share with linkedin Share with facebook. Abstract Aim The aim of this article is to evaluate the clinical and cost implications of failed endoscopic hemostasis in patients with gastroduodenal ulcer bleeding. Methods A retrospective claims analysis of the Medicare Provider Analysis and Review MedPAR file was conducted to identify all hospitalizations for gastroduodenal ulcer bleeding in the year Conclusions Failure to achieve hemostasis at the index endoscopy has significant clinical and cost implications.

Free full text. United European Gastroenterol J. Published online Aug 2. PMID: Author information Article notes Copyright and License information Disclaimer. Corresponding author. Rollins St. Email: moc. Received Apr 29; Accepted Jul This article has been cited by other articles in PMC. Go to:. Aim The aim of this article is to evaluate the clinical and cost implications of failed endoscopic hemostasis in patients with gastroduodenal ulcer bleeding.

Keywords: Peptic ulcer bleeding, endoscopy, outcomes, costs, interventional radiology, surgery. Patient population The study population consisted of all patients who had claims for receiving a blood transfusion and underwent an UGI endoscopy for gastroduodenal ulcer bleeding. Statistical analysis All analyses were performed using SAS version 9. Table 1. Baseline demographics and comorbid conditions of patients. Open in a separate window. To avoid inputting the values, other cells may be masked.

Figure 1. Table 2. Summary of the main outcome measures. A Roy: study design, data analysis, drafting of the manuscript. M Kim: study design, acquisition of data, analysis, drafting of the manuscript. R Hawes: concept and design, analysis, drafting of the manuscript. Laine L, Peterson WL. Bleeding peptic ulcer. New Engl J Med ; : — Acute upper gastrointestinal bleeding in the UK: Patient characteristics, diagnoses and outcomes in the UK audit.

Gut ; 60 : — Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med ; : — A systematic review of transarterial embolization versus emergency surgery in treatment of major nonvariceal upper gastrointestinal bleeding. Clin Exp Gastroenterol ; 7 : 93— Guideline development group management of acute upper gastrointestinal bleeding: Summary of NICE guidance.

BMJ ; : e—e A comparison of angiography embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers. Gastrointest Endosc ; 73 : — Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure. J Vasc Interv Radiol ; 19 : — Systematic review of the predictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers.

Am J Gastroenterol ; : — Effect of programmed endoscopic follow-up examinations on the rebleeding rates of gastric and duodenal peptic ulcers treated by injection therapy: A prospective, randomized controlled trial. Endoscopy ; 30 : — Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: Results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol ; 33 : — Surgical management of peptic ulcer bleeding by Australian and New Zealand upper gastrointestinal surgeons.

ANZ J Surg ; 83 : — Causes of mortality in patients with peptic ulcer bleeding: A prospective cohort study of 10, cases. Am J Gastroenterol ; : 84— Laine L, Jensen DM. Management of patients with ulcer bleeding. American College of Gastroenterology Practice Guidelines. Full text links Read article at publisher's site DOI : Smart citations by scite. The number of the statements may be higher than the number of citations provided by EuropePMC if one paper cites another multiple times or lower if scite has not yet processed some of the citing articles.

Explore citation contexts and check if this article has been supported or disputed. Over-the-scope clip in peptic ulcer bleeding: clinical success in primary and secondary treatment and factors associated with treatment failure. Impaired activity of daily living is a risk factor for high medical cost in patients of non-variceal upper gastrointestinal bleeding.

Radiographics — PubMed Article Google Scholar. Adler DG, Baron TH Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol — Maetani I, Tada T, Ukita T, Inoue H, Sakai Y, Nagao J Comparison of duodenal stent placement with surgical gastrojejunostomy for palliation in patients with duodenal obstructions caused by pancreaticobiliary malignancies.

Endoscopy — J Gastrointest Cancer 38 2—4 — J Gastrointest Surg — Ann Surg — Int J Gastrointest Cancer 35 3 — Surg Laparosc Endosc 8 2 — Br J Surg 91 2 — Gastroenterostomy vs endoscopic stenting: a randomized prospective trial. Anticancer Res — PubMed Google Scholar. Johnsson E, Thune A, Liedman B Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting: clinical outcome and health economic evaluation.

World J Surg — Br J Surg — Gastrointest Endosc — Download references. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author s and the source are credited. You can also search for this author in PubMed Google Scholar. Reprints and Permissions. Roy, A. Stenting versus gastrojejunostomy for management of malignant gastric outlet obstruction: comparison of clinical outcomes and costs.

Surg Endosc 26, — Download citation. Received : 19 October Accepted : 02 April Published : 02 May Issue Date : November Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

Skip to main content. Search SpringerLink Search. Download PDF. Abstract Background Although endoscopic stenting is increasingly performed, surgical gastrojejunostomy GJ is still considered the gold standard for relief of malignant gastric outlet obstruction GOO. Conclusions While the technical and clinical outcomes of surgical GJ and endoscopic stenting appear comparable, stent placement is less costly and is associated with shorter length of hospital stay.

Patients and methods This study was conducted in two parts: First, Medicare Provider Analysis and Review MedPAR inpatient hospitalization data were utilized to evaluate hospital costs and length of stay LOS for patients who underwent gastrojejunostomy or endoscopic duodenal stenting for relief of malignant gastric outlet obstruction.

Patient population The study population consisted of all unique hospitalization claims for a GJ procedure or endoscopic placement of a duodenal stent. Outcome measures Using the MedPAR claims data, the total LOS from admission to discharge and the total costs associated with each technique were compared.

Institutional data As MedPAR is a claims database that does not provide outcomes at a patient level, a single-institution retrospective case-control study was conducted where each patient who underwent stent placement was matched with two gastrojejunostomy patients having procedures in the period — Surgical GJ Briefly, after making a midline incision, a small opening was made into both the posterior wall of the stomach and the jejunal loop with a Harmonic scalpel.

Outcome measures The rates of treatment success, complications, re-interventions, and length of post-procedure hospital stay were compared between each treatment modality. Consent All patients provided informed consent to undergo the procedures, and the study was approved by the University of Alabama at Birmingham Institutional Review Board. Institutional data Statistical analysis was performed by using Stata 9.

Table 1 Patient characteristics for stent and surgery groups institutional data Full size table. Table 2 Clinical outcomes for stent and surgery groups institutional data Full size table. Table 3 Baseline demographics and comorbid conditions of the stent placement and gastrojejunostomy patient populations as reported in — MedPAR claims MedPAR data Full size table.

Full size image. Discussion The main objective of a palliative procedure in patients with malignant GOO is to restore their ability to eat.

References 1. Dissemination of endoscopic stenting beyond teaching, academic hospitals located in urban areas as a treatment for malignant GOO is important given its implications for patient care and resource utilization.

Abstract Background: Although endoscopic stenting is increasingly performed, surgical gastrojejunostomy GJ is still considered the gold standard for relief of malignant gastric outlet obstruction GOO.

Publication types Comparative Study.