UNASSIGNED: Abstract Objective. In 5-10% of @entity1 with peptic ulcer @entity548 (PUB) it is impossible to achieve endoscopic hemostasis because of severe @entity548 . These @entity1 have traditionally been treated surgically. Transcatheter @entity1416 (TAE) may, however, be associated with a better outcome because of the less-invasive nature of the procedure. The aim of the present study was to identify the treatment of choice in endoscopy-refractory PUB. Materials and methods. A retrospective study. Consecutive @entity1 treated with surgery or TAE for endoscopy-refractory PUB during a period of 16 years at a university hospital were included. Primary hemostasis, rebleeding rate, mortality, and complications were assessed. Mortality was compared between groups after adjustment for age, comorbidity, and @entity417 using logistic regression analyses. Comorbidity was quantified using the Charlson comorbidity index (CCI). Results. One hundred and eighteen @entity1 were included. @entity1 treated with TAE had a higher CCI (mean: 2.33 vs 1.42; p = .003), and more severe @entity417 (mean: 6.8 vs 7.9 g/dl; p = .007) compared with @entity1 treated with surgery. Surgery was associated with a higher rate of primary hemostasis (100% vs 91%; p = .007), lower rate of rebleeding (15% vs 40%; p = .004) but also higher rate of complications (60% vs 38%; p = .02) than TAE. Surgery was associated with an increased mortality (Odds ratio: 3.05; p = .033) when adjusting for confounding factors and excluding @entity1 (n = 3) who were not candidates for both interventions. Conclusions. We propose use of TAE as first-line therapy in these @entity1 as it may be associated with lower mortality and lower rate of complications compared with surgery.

Transcatheter @entity1416 is the first-line therapy of choice in peptic ulcer XXXX not responding to endoscopic therapy.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1416 :: ('MESH:D020762', 'Disease') :: ['arterial embolization'] @entity417 :: ('MESH:D000740', 'Disease') :: ['anemia'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
