Predictors of Endoscopic Treatment Failure for Peptic Pyloro-Bulbar Stenosis

Aims Pylorobulbar stenosis is a late complication of peptic ulcer disease. Endoscopic treatment is an alternative to surgical treatment. The aim of our work was to determine the predictors of endoscopic treatment failure.

Methods This is a retrospective study that included all patients with peptic ulcer disease complicated with pyloro-bulbar stenosis during the period between 1996 and 2017 and who had endoscopic dilation. The statistical study was carried out by SPSS software (p<0.1).

Results We included 73 patients (62 men and 11 women) with an average age of 51 years [20-81]. Smoking and intake of non-steroidal anti-inflammatory drugs were found in 70 % and 4 % of patients, respectively . The circumstance of discovery was gastric outlet obstruction syndrom (n = 53) or epigastric pain (n = 20). The mean duration of symptoms was 18.6 months. The mean number of endoscopic dilations was 1.7 [1-4]. The maximum diameter used was on average 17.3 mm [16-28]. Fifty patients (72.5 %) had a good response. Complications of dilation were: minor bleeding (n = 42) and perforation (n = 2). Surgical treatment was performed in 22 patients. The mean duration of follow-up was 11.5 months [0-156]. The only predictor of endoscopic treatment failure was smoking (p = 0.077). There was no correlation between age (p = 0.426), sex (p = 0.135), non-steroidal anti-inflammatory drugs intake (p = 0.818), a prolonged period before consultation (p = 0.736), the persistence of HP (p = 0.919) and the success of endoscopic treatment.

Conclusions Endoscopic treatment combined with eradication of HP is an effective treatment of peptic pylorobulbar stenosis. Smoking is a predictor of endoscopic treatment failure.

Citation: Ben Mohamed A, Nakhli A, Khsiba A et al. eP152 PREDICTORS OF ENDOSCOPIC TREATMENT FAILURE FOR PEPTIC PYLORO-BULBAR STENOSIS. Endoscopy 2021; 53: S146.

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Artikel online veröffentlicht:
19. März 2021