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.
Mohandas
K M
KM
Department of Gastroenterology, Tata Memorial Hospital, Bombay, India.
Swaroop
V S
VS
Desai
D C
DC
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