Treatment of choice for bleeding gastric ulcer is

Bleeding gastric ulcers. Treatment of bleeding gastric ulcers depends on their cause and location; however, the initial approach is similar to duodenal ulcers. Patients require resuscitation, monitoring, and endoscopic investigation. Up to 70% of gastric ulcers are H. pylori-positive, so an attempt should be made to control the bleeding endoscopically, with multiple biopsy specimens of the ulcer obtained to rule out malignancy and concurrently obtained biopsy specimens of the body and antrum to test for H.pylori infection. Patients whose bleeding can be controlled and who are H. pylori-positive should undergo subsequent treatment for H. pylori infection. For bleeding that cannot be controlled, operative intervention again depends on the type of gastric ulcer. In all cases, the ulcer should ideally be excised with the addition of vagotomy depending on the cause of the ulcer (mostly for intractable ulcers that are not due to H. pylori infection or NSAID usage that can be stopped). Ref: Sabiston Textbook of Surgery 20th edition Pgno: 1209