Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction - 23/08/11
Reprint requests: Rakesh Kochhar, MD, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.Chandigarh, India
Abstract |
Background |
The standard treatment of caustic-induced gastric outlet obstruction (GOO) is surgery. There are only a few reports in the medical literature on endoscopic balloon dilation (EBD) for caustic-induced GOO.
Objective |
To study the short-term and long-term response of EBD in patients with caustic-induced GOO.
Setting |
Tertiary-care center in India.
Design |
Retrospective analysis of data.
Patients |
Of the 49 patients with caustic-induced GOO seen by us between January 1998 and December 2003, 41 were treated by EBD. Thirty-seven patients had consumed an acid and 4 had consumed an alkali a mean (SD) of 19.5 ± 14.5 weeks earlier. EBD was performed every 3 weeks by using through-the-scope balloons under endoscopic guidance.
Intervention |
The balloon was negotiated across the narrowed segment and inflated for 60 seconds by using a pressure gun. Balloons of incremental diameters, up to a maximum of 3 sizes, were used in each sitting. The end point of dilation was 15 mm, after which patients were assessed for recurrence. The patients were observed until August 2007.
Results |
All 41 patients (23 men; mean [SD] age 29.6 ± 8.5 years) could be successfully taken for EBD. Thirty-nine patients underwent successful repeated dilations, which required a mean (SD) of 5.8 ± 2.6 dilations (range 2-13) to achieve the end point of 15 mm. All 39 patients were followed up for an average (SD) of 35.4 ± 11.1 months (range 18-58 months). The mean (SD) size of the first dilator was 8.2 ± 0.6 mm (range 8-10 mm). One patient had a perforation and was subjected to antrectomy; another patient had pain every time he received EBD; he also had surgery. Other complications were minor: self-limiting pain (n = 8) or bleeding (n = 7).
Conclusions |
EBD is a safe, effective, and long-lasting alternative to surgery for caustic-induced GOO.
Le texte complet de cet article est disponible en PDF.Abbreviations : CRE, EBD, GOO, TTS
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| If you want to chat with an author of this article, you may contact him at dr_kochhar@hotmail.com. |
Vol 69 - N° 4
P. 800-805 - avril 2009 Retour au numéro
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