Dilation of difficult gastrointestinal strictures using a modified wire-guided technique.
We describe here 18 patients with gastrointestinal strictures through which a standard guide wire could not be passed, and which were dilated using a modified technique. After a 0.035" guide wire had been passed through a 5-Fr metal-tipped catheter, the narrow strictures were dilated using a 10-Fr biliary dilator. A modified Savary-Gilliard guide wire (olive-tipped with a hole) was passed over the 0.035" guide wire beyond the stricture. After removing the 0.035" guide wire, the strictures were dilated with Savary-Gilliard dilators passed over the olive-tipped guide wire. Seventeen patients had upper gastrointestinal strictures, and one had a sigmoid colon stricture. The strictures were caused by tumor in two, radiation therapy in six, esophagogastric resection for cancer in five, and a combination of two or more factors in five patients. The modified technique was successful in 17 patients, without any complications. Adequate symptomatic relief was achieved in 15 patients.
Department of Gastroenterology, Tata Memorial Hospital, Bombay, India.
K M
KM
Mohandas
V S
VS
Swaroop
D C
DC
Desai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D004106:Dilatation / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged