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© Georg Thieme Verlag Stuttgart · New York
Long-Term Results of Balloon Catheter Dilation for Benign Gastric Outlet Stenosis
Submitted 31 May 2002
Accepted after Revision 16 January 2003
03 June 2003 (online)
Background and Study Aims: In 1981, the authors introduced balloon catheter dilation for postoperative gastric outlet stenosis and later for peptic, corrosive and postvagotomy gastric outlet stenosis. This retrospective study evaluates the effectiveness, safety and outcome of balloon catheter dilation in these various indications.
Patients and Methods: Between September 1981 and September 2001, 177 balloon catheter dilation procedures were carried out in 72 patients with benign stenoses. Double-lumen or single-lumen balloon catheters with a mean diameter of 18 mm (range 12 - 25 mm) were used. Endoscopic check-up examinations were carried out 1 - 3 weeks later, and then after three, six and 12 months, or if symptoms returned. The mean follow-up period for patients who did not undergo surgery was 98 months (range 12 - 240 months).
Results: Symptomatic relief was obtained immediately in 80 % and after 3 months or more in 70 % of the patients. The mean diameter of the stenoses was 6 mm (2.0 - 9.5 mm) before dilation and 16 mm (10 - 20 mm) afterwards. Gastric retention was observed in 49 patients (68 %) before dilation and in 19 patients (26.4 %) afterward. Sixteen patients had recurrent stenosis 1 - 18 months after the first dilation. All of the 18 postoperative strictures, 21 (70 %) of the 30 peptic stenoses, six (35 %) of the 17 patients with corrosive strictures, and five of the six patients with postvagotomy functional stenosis were successfully treated with dilation. Pyloric perforation occurred in two cases, and arterial hemorrhage was observed in one case after dilation.
Conclusions: Balloon catheter dilation is an important and effective diagnostic and therapeutic method; depending on the causative factor, it can make surgery unnecessary in nearly 70 % of patients with benign gastric outlet stenosis.
- 1 Solt J, Rauth J, Horváth L. Gezielte Dilatation benigner Oesophagusstenosen mit einem Ballonkatheter. Extr Gastroenterol. 1981; 10 313-323
- 2 Solt J, Rauth J, Papp Z, Bohenszky G. Balloon catheter dilation of postoperative gastric outlet stenosis. Gastrointest Endosc. 1984; 30 359-361
- 3 Solt J, Papp Z, Rauth J, Bohenszky G. Balloon catheter dilatation of postoperative stenosis of the gastric outlet (in Hungarian). Orv Hetil. 1986; 127 1643-1646
- 4 Graham D Y, Tabibian N, Schwartz J T, Smith J L. Evaluation of the effectiveness of through-the-scope balloons as dilators of benign and malignant gastrointestinal strictures. Gastrointest Endosc. 1987; 33 432-435
- 5 Craig P I, Gillespie P E. Through the endoscope balloon dilatation of benign gastric outlet obstruction. BMJ. 1988; 297 396
- 6 Benjamin S B, Cattau E L, Glass R L. Balloon dilation of the pylorus: therapy for gastric outlet obstruction. Gastrointest Endosc. 1982; 28 253-254
- 7 Benjamin S B, Glass R L, Cattau Jr E L, Miller W B. Preliminary experience with balloon dilation of the pylorus. Gastrointest Endosc. 1984; 30 93-95
- 8 Lindor K D, Ott B J, Hughes R W. Balloon dilatation of upper digestive tract strictures. Gastroenterology. 1985; 89 545-548
- 9 Hegedus V, Raaschou H O. Radiologically guided dilatation of stenotic gastroduodenal anastomosis. Gastrointest Radiol. 1986; 11 27-29
- 10 Hogan R B, Hamilton J K, Polter D E. Preliminary experience with hydrostatic balloon dilation of gastric outlet obstruction. Gastrointest Endosc. 1986; 32 71-74
- 11 McLean G K, Cooper G S, Hartz W H. et al . Radiologically guided balloon dilation of gastrointestinal strictures, 1: technique and factors influencing procedural success. Radiology. 1987; 165 35-40
- 12 McLean G K, Cooper G S, Hartz W H. et al . Radiologically guided balloon dilation of gastrointestinal strictures, 2: results of long-term follow-up. Radiology. 1987; 165 41-43
- 13 Schmudderich W, Harloff M, Riemann J F. Through-the-scope balloon dilatation of benign pyloric stenoses. Endoscopy. 1989; 21 7-10
- 14 Kozarek R A, Botoman V A, Patterson D J. Long-term follow-up in patients who have undergone balloon dilation for gastric outlet obstruction. Gastrointest Endosc. 1990; 36 558-561
- 15 Kuwada K S, Alexander G L. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis. Gastrointest Endosc. 1995; 41 15-17
- 16 Lau J YW, Chung S CS, Sung J JY. et al . Through-the-scope balloon dilation for pyloric stenosis: long-term results. Gastrointest Endosc. 1996; 43 98-101
- 17 Hemphil D J, Marcon N E, Korton P. et al . Predictors of success of endoscopic dilation of benign gastric outlet obstruction during long-term follow-up (abstract). Gastrointest Endosc. 1995; 41 364
- 18 Murthy U K. Repeated hydrostatic balloon dilation in obstructive gastroduodenal Crohn's disease. Gastrointest Endosc. 1991; 37 484-485
- 19 Vij J C, Ramesh G N, Choudhary V, Malhotra V. Endoscopic balloon dilation of tuberculous duodenal strictures. Gastrointest Endosc. 1992; 38 510-511
- 20 Misra S P, Dwivedi M. Long-term follow-up of patients undergoing balloon dilation for benign pyloric stenoses. Endoscopy. 1996; 28 552-554
- 21 Hogan R B, Polter D E. Nonsurgical management of lye-induced antral stricture with hydrostatic balloon dilation. Gastrointest Endosc. 1986; 32 228-230
- 22 Steele R J, Munro A. Successful treatment of gastric stasis following proximal gastric vagotomy using endoscopic balloon dilatation. Endoscopy. 1989; 21 120
J. Solt, M.D., Ph.D.
First Department of Medicine · Baranya County Hospital
Rákóczi u. 2. · 7623 Pécs · Hungary
Fax: + 36-72-256752
Email: [email protected]