First experience of using bleeding source determining method at the height of hemorrhage in endoscopy
The aim of the research is evaluation of the effectiveness of bleeding source determining method at the height of hemorrhage in endoscopy using the indocyanine green solution. Material and methods. The method was applied to 18 patients brought with a clinical picture of gastrointestinal bleeding by an ambulance. The study was performed in operating or resuscitation rooms, in the presence of anesthesiologist-resuscitator in case of allergic reaction or the need for emergency surgical treatment. Fluorescence and narrow-spectrum imaging were used, along with indocyanine green solution (Germany) (0.125 mg / ml water) - 40 ml, high-frequency surgical device “BOWAAKC 350 PLUS” (Germany). Results. Bleeding sources: chronic gastric and duodenal ulcers - 8 cases (44.5 %), Mallory-Weiss syndrome was detected in 6 patients (33.3 %), acute gastric ulcer - 4 patients (22.2 %). In 10 patients (55.5 %) bleeding activity was regarded as Forrest IA. In 8 cases (44.5 %) - as Forrest IB. For the first time in Novosibirsk, endoscopic visualization of bleeding source by means of indocyanine green solution (Germany) with subsequent haemostasis was applied. In all patients with intensive bleeding, there was good visualization of the bleeding source. Clear visualization of bleeding source during washing the mucous membrane with indocyanine green, combined with infrared light mode examination, was obtained due to differences in blood colour glow of the one present in the stomach lumen, that is coloured by the preparation and the fresh one coming from the bleeding source. Conclusion. The first experience of using indocyanine green in emergency endoscopy in surgical patients was positive. It is advisable to study it further with subsequent analysis of the obtained results, specification of technique recommendations and spread of clinical application range. First experience of using bleeding source determining method at the height of hemorrhage in endoscopy