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Beburishvili A.G.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Fedorov A.V.

Almasov National Medical Research Centre, 197341, St. Petersburg, Russia

Sazhin V.P.

Kafedra khirurgii i OVP s kursom éndokhirurgii fakul'teta poslediplomnogo obrazovaniia Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. akad. I.P. Pavlova, Novomoskovskaia gorodskaia klinicheskaia bol'nitsa

Panin S.I.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Zyubina E.N.

Volgograd State Medical University, Department of Faculty Surgery with the course of endoscopic surgery and with the course of Cardiovascular Surgery, Faculty of Continuing Medical Education, Center for Surgical Hepatology

Surgical treatment of ulcerative pyloroduodenal stenosis

Authors:

Beburishvili A.G., Fedorov A.V., Sazhin V.P., Panin S.I., Zyubina E.N.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(4): 94‑99

DOI: 10.17116/hirurgia201904194

Views: 2206

Downloaded: 156

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To cite this article:

Beburishvili AG, Fedorov AV, Sazhin VP, Panin SI, Zyubina EN. Surgical treatment of ulcerative pyloroduodenal stenosis. Pirogov Russian Journal of Surgery. 2019;(4):94‑99. (In Russ.)
https://doi.org/10.17116/hirurgia201904194

Подписка 2025 (Pirogov Russian Journal of Surgery)
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Aim — to obtain the most reliable information about surgical treatment of ulcerative pyloroduodenal stenosis based on the methodology of evidence-based medicine. Material and methods. Searching platforms were elibrary, Cochrane Library and PubMed database. The probability of major systematic errors in randomized controlled trials (RCTs) was evaluated. Results. Systematic review included 20 RCTs for the period 1968—2009 with overall sample of 1794 patients. Evaluation of external validity allows to generalize the results of these studies to the entire population of patients with ulcerative pyloroduodenal stenosis. Assessment of internal validity based on the number of systematic errors showed that 7 (35%) of 20 of RCTs corresponded to the highest level of evidence (level 1), 13 (65%) of 20 had systematic errors and were downgraded in the rating (level 1–). Significant heterogeneity of RCTs impedes metaanalysis. Conclusions and practical recommendations for the treatment of ulcerative pyloroduodenal stenosis are formed according to the results of individual RCTs. Conclusion. Selective vagotomy may be performed for functional stenosis. In case of organic stenosis, truncal vagotomy should be combined with drainage surgery (pyloroplasty, gastroenterostomy) or Roux/Billroth-1 antrectomy. Treatment of decompensated stenosis within evidence-based medicine is unclear. We have not identified target researches with evidence level 1 for this form of stenosis.

Keywords:

peptic ulcer
complications
stenosis

Authors:

Beburishvili A.G.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Fedorov A.V.

Almasov National Medical Research Centre, 197341, St. Petersburg, Russia

Sazhin V.P.

Kafedra khirurgii i OVP s kursom éndokhirurgii fakul'teta poslediplomnogo obrazovaniia Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. akad. I.P. Pavlova, Novomoskovskaia gorodskaia klinicheskaia bol'nitsa

Panin S.I.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Zyubina E.N.

Volgograd State Medical University, Department of Faculty Surgery with the course of endoscopic surgery and with the course of Cardiovascular Surgery, Faculty of Continuing Medical Education, Center for Surgical Hepatology

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