Minimally invasive technologies in the treatment of ulcerative pylorobulbar stenosis
Background. The purpose was to develop approaches to minimally invasive treatment of patients with ulcerative pyloroduodenal stenosis. Materials and methods. In 2015–2018, at the department of surgery of the digestive organs of the State Institution “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, 36 patients with ulcerative pyloroduodenal stenosis were treated using endoscopic, combined laparoendoscopic and laparoscopic operative techniques, of them isolated endoscopic balloon dilation of the pylorus was performed in 27 patients, combined laparoendoscopic intervention — in 9 persons. There were 24 men and 12 women, with the mean age of (45.3 ± 5.2) years. Results. Compensated stenosis was diagnosed in 7 patients (19.5 %), subcompensated — in 21 (58.3 %), decompensated — in 8 (22.2 %). During the study, we specified and developed the well-known and new indications for endoscopic balloon dilation of the pylorus and duodenum and combined laparoendoscopic intervention performed in all patients, depending on the degree of pyloric stenosis. Complications in the immediate postoperative period occurred in 1 patient (2.7 %) in the form of perforation of the dilation zone. There were no lethal outcomes. The remote observation period was 7–12 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of ulcerative pyloroduodenal stenosis is characterized by minimal complications, good efficacy and the absence of disease recurrences in the long-term period.
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Didigov MT, Klyuchnikov OYu. Surgical treatment of decompensated cicatrical-ulcerative duodenal stenosis: resection of the stomach or diametrical duodenoplasty. V mire nauсnyh otkrytij. 2013;2(47):175-196. (in Russian).
Croce E, Olmi S, Russo R, Azzola M, Mastropasqua E, Golia M. Laparoscopic treatment of peptic ulcers. A review after 6 years experience with Hill-Barker's procedure. Hepatogastroenterology. 1999 Mar-Apr;46(26):924-9.
Durleshter VM, Didigov MT. Method of radical duodenoplasty decompensated the length of scar and ulcerative stenosis of the duodenum. Kubanskii nauchnyi meditsinskii vestnik. 2013;(142):79-81. (in Russian).
ASGE Standards of Practice Committee, Banerjee S, Cash BD, et al. The role of endoscopy in the management of patients with peptic ulcer disease. Gastrointest Endosc. 2010 Apr;71(4):663-8. doi: 10.1016/j.gie.2009.11.026.
Cherian PT, Cherian S, Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy. Gastrointest Endosc. 2007 Sep;66(3):491-7. doi: 10.1016/j.gie.2006.11.016.
Kochhar R, Poornachandra KS, Dutta U, Agrawal A, Singh K. Early endoscopic balloon dilation in caustic-induced gastric injury. Gastrointest Endosc. 2010 Apr;71(4):737-44. doi: 10.1016/j.gie.2009.11.038.
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