Endoscopic balloon dilation for ulcer-induced gastric outlet obstruction.

Abstract

To determine the safety and efficacy of endoscopic balloon dilation for ulcer-induced gastric outlet strictures. Review of the cumulative experience from two institutions involving 30 patients who underwent endoscopic balloon dilation for peptic ulcer-induced gastric outlet obstruction. Follow-up was by standardized interview at a mean of 15 months (range 4-28 months). Symptoms occurred for an average of 6 months before dilation and included weight loss, epigastric pain, nausea, vomiting, early satiety, bloating, and anorexia. Gastric outlet strictures had a median diameter of 6 mm (range, 0-10 mm). Ten (33%) patients had active ulcers. Six-millimeter to 18-mm (median 15-mm) balloons were inflated a median of 2 times (range 1-4 times) for a median of 60 s (range 30-180 s). Fifty-one procedures (1.7/patient) were performed; 20 (67%) patients had one treatment and 10 (33%) had multiple treatments. Twenty-four (80%) patients achieved sustained symptom relief, 17 of 20 having a single procedure and 7 of 10 required multiple sessions. Dilation failed in 4 (13%) patients with long duodenal strictures. Two (6.7%) patients dilated to 18 mm suffered perforation. Both recovered uneventfully after surgery. Endoscopic balloon dilation is safe and effective for most patients with ulcer-induced gastric outlet obstruction.