Surgical management of gastrointestinal bleeding

The role of surgery in gastrointestinal (GI) bleeding has recently diminish ed because of the development of effective endoscopic and interventional ra diologic therapies. Nevertheless, operation remains an important salvage st rategy for failure of less invasive interventions and is required in most p atients with bleeding GI neoplasms other than small benign polyps. Operatio ns for upper GI tract bleeding are often designed to address the specific p athophysiology responsible for the bleeding lesion. Operations for lower GI tract bleeding more commonly entail simple segmental bowel resections that encompass the bleeding lesion. The combined application of endoscopic and laparoscopic techniques now provides a minimally invasive alternative to tr eat a highly selected group of patients with GI bleeding.