Classic indications for operation for rebleeding after endoscopic therapy
After two attempted endoscopic therapeutic interventions for a bleeding peptic ulcer, patients who have already required six units of blood should be strongly considered for surgical intervention.
In general, the indications for surgical treatment of a bleeding peptic ulcer are:
- Hemodynamic instability as a result of massive hemorrhage (after cardiovascular stabilization)
- Need for multiple transfusions caused by continued bleeding
- Failure of nonsurgical therapy to prevent re-bleeding
