Manometry is a rather effective method of assessing motor-kinetic function in patients with various gastrointestinal diseases. However, the comparison of different manometry techniques in the evaluation of the tone of the pyloroduodenal zone in patients with ulcerative genesis of stenosis showed a significant advantage of the balloon pressure measurement method over the open catheter method. The purpose of the work was to evaluate the motor-kinetic function of the pyloroduodenal sphincter in patients with pyloroduodenal stenosis of ulcerative origin. Material and methods. 92 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined in the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019. Depending on the degree of stenosis, the patients were divided into 2 groups: group I included 35 patients with compensated stenosis, group II encompassed 57 patients with subcompensated stenosis. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive surgery. Balloon manometry was used to register the tonus of the stenosis region of the pyloroduodenal zone. Results and discussion. The obtained results showed that the average value of the pressure level in group II was (63.5±2.1) mm Hg. Art., which was by 2.2 times (p <0.001) higher compared with group I (29.5±1.6) mm Hg. Art. and by 3.7 times (p <0.001) compared with patients in the control group (17.3±1.5) mm Hg. Art. ROC analysis on the use of the pressure level of the pyloroduodenal zone according to manometry as a diagnostic criterion for the degree of stenosis made it possible to establish a high quality diagnostic model for compensated (AUC=0,846 (95% СІ 0,723-0,929; р<0,0001) and subcompensated (AUC=0,924 (95% СІ 0,853-0,967; р<0,0001) stenoses. We proved that manometry using the balloon method had a clear correlation with endoscopic and radiographic methods in diagnosing the degree of stenosis and evaluating the long-term results of treatment of patients with pyloroduodenal stenosis. The balloon manometry method showed high sensitivity (88.1%) and specificity (82.4%) of data in the establishment of both compensated and subcompensated ulcerative genesis and evaluation of long-term treatment results. Conclusion. Performing manometry in patients with pyloroduodenal stenosis of ulcerative genesis promotes a differentiated choice of the method of surgical treatment, namely endoscopic or endolaparoscopic, which allows you to save the function of the pylorus.
Keywords: peptic ulcer, pyloroduodenal stenosis, manometry, endoscopic balloon pyloric and duodenoplasty, endolaparoscopic interventions
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