Efficacy and safety of Helicobacter pylori eradication therapy immediately after endoscopic submucosal dissection

Yoshiaki Takahashi, Toshihisa Takeuchi, Yuichi Kojima, Yasuaki Nagami, Masaki Ominami, Noriya Uedo, Kenta Hamada, Haruhisa Suzuki, Ichiro Oda, Youichi Miyaoka, Satoshi Yamanouchi, Satoshi Tokioka, Naoya Tomatsuri, Norimasa Yoshida, Yuji Naito, Takashi Nonaka, Shinya Kodashima, Shinichi Ogata, Yasushi Hongo, Tadayuki OshimaZhaoliang Li, Kotaro Shibagaki, Tomoyuki Oikawa, Kazunari Tominaga, Kazuhide Higuchi

Research output: Contribution to journalArticlepeer-review


Background and Aims: In the treatment of patients after endoscopic submucosal dissection (ESD), there is no consensus on the optimum time to start Helicobacter pylori eradication therapy or on whether eradication therapy improves ulcer healing rate after ESD. The aim of this study was to examine the effect of immediate eradication of H. pylori on ulcer healing after ESD in patients with early gastric neoplasms. Methods: A total of 330 patients who underwent ESD for early gastric neoplasms were enrolled. Patients were assigned to either H. pylori eradication group (Group A: H. pylori eradication + proton pump inhibitor 7 weeks) or non-eradication group (Group B: proton pump inhibitor 8 weeks). The primary end point was gastric ulcer healing rate (Group A vs Group B) determined on week 8 after ESD. Results: Patients in Group A failed to meet non-inferiority criteria for ulcer scarring rate after ESD compared with that in Group B (83.0% vs 86.5%, P for non-inferiority = 0.0599, 95% confidence interval: −11.7% to 4.7%). There were, however, neither large differences between the two groups in the ulcer scarring rate nor the safety profile. Conclusions: This study failed to demonstrate the non-inferiority of immediate H. pylori eradication therapy after ESD to the non-eradication therapy in the healing rate of ESD-caused ulcers. However, because the failure is likely to attribute to small number of patients enrolled, immediate eradication therapy may be a treatment option for patients after ESD without adverse effects on eradication therapy in comparison with the standard therapy.

Original languageEnglish
Pages (from-to)1341-1346
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number7
Publication statusPublished - Jul 2018
Externally publishedYes


  • endoscopic submucosal dissection
  • eradication therapy
  • Helicobacter pylori
  • proton pump inhibitor

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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