Possibilities of using thrombin in diagnostic and therapeutic fibrogastroduodenoscopy for gastrointestinal bleeding

Abstract

The issue of gastrointestinal bleeding has been relevant for several decades, and the mortality rate as a result of this pathology ranges within 10 %. Against the background of the impossibility of timely surgical intervention or in the presence of serious contraindications to surgical treatment, an alternative may be to improve the methods of non-operative hemostasis, namely, the combination of endoscopic manipulations with medication. Endoscopic methods of stopping bleeding include thermal, mechanical and injection. Most often, physicians resort to the use of adrenaline (leading to a state of vasoconstriction), various sclerosing drugs (in particular, ethyl alcohol), the action of which is aimed at providing chemical coagulation, as well as thrombin and fibrin glue, leading to local thrombus formation, as medications. Therapeutic endoscopy for gastrointestinal bleeding has a fairly high efficiency and helps to stop bleeding, which in most cases allows preparing the patient for surgery and in some cases helps to prevent relapse and translates the need for surgical treatment into the category of planned operations. The use of thrombin in such practice is limited by the impossibility of carrying out hemostasis under conditions of bleeding from large vessels, the risk of transmission of blood-borne infections and the low availability of this drug.