Efficacy and Complications of Endoscopic Balloon Dilation in Treatment of Benign Gastric Outlet Obstruction

Abstract

Background: Gastric outlet obstruction (GOO) due to peptic stricture is one of three known complications of peptic ulcer disease and usually requires therapeutic intervention for symptoms relief. After Benjamin SB who primarily used balloon dilation for treatment of GOO in 1982, some series has been published investigating procedure efficacy with different results. The purpose of this study is to investigate efficacy of balloon dilation in some Iranian patients with GOO and also the probable role of some other factors on responsiveness.

Materials and Methods: 23 patients were enrolled in a 10 month duration prospective case study and followed for mean of 30 weeks. some factors such as gender, age, cigarette smoking, Helicobacter pylori (H.p) infection, stenosis diameter, symptom duration, degree of weight loss, dilation sessions, response to therapy and time to response after procedure were registered for each patient.

Results: Mean age was 49.5 years and most patients were in the 5th decade of life. 2 and 23 of patients (8.7% and 91.3%) were female and male, respectively. the most common symptoms among patients were epigastric fullness and heart burn (each 87% of patients), nausea (82.6), vomiting (78.3%) and pain (69.6%). 21 out of 23 patients were asymptomatic at end of study. 18 of 21 patients with response to therapy underwent only one session of dilation. There was not any statistically significant correlation between response to therapy and any one of factors as, gender, H.p infection, cigarette smoking, symptom duration and stenosis diameter. Time to response was shorter in males comparing to females (2.7 vs 8 weeks respectively) (p=0.002).

Conclusions: Trans the scope (TTS) balloon dilation of GOO in short term is effective and safe. if in long term, symptom recurrence rate proves to be acceptable, it will be recommended as first line treatment of benign GOO. Also it seems that use of fluoroscopy has not any additional advantage in increasing efficacy of the procedure.