A new endoscopic technique for the removal of gastric phytobezoars.
BACKGROUND
There is no standardized method for the evacuation of gastric phytobezoars. Prior endoscopic attempts have used injected cellulase and various devices to disrupt bezoars. The efficacy of directed, large-channel suction using an endoscope for the removal of large gastric phytobezoars is the subject of this study.


METHODS
Three consecutive patients with large gastric bezoars were examined. Phytobezoar removal using a standard endoscope (GIF-100, Olympus) was attempted but unsuccessful. Each phytobezoar was successfully evacuated by directed suction through an endoscope with a large-diameter accessory channel (GIF-XT30, Olympus). Each patient was followed up for bezoar recurrence.


RESULTS
Rapid, complete bezoar evacuation was achieved at one session in all patients. Aspirated volumes were 500, 700, and 1000 mL. There were no procedure-related complications.


CONCLUSIONS
Endoscopic suction removal of gastric phytobezoars using a large-channel endoscope is efficacious and safe. Coupling directed endoscopic suction with other endoscopic techniques might be efficacious for removal of more complex bezoars.
Blam
M E
ME
Hospital of the University of Pennsylvania, University of Pennsylvania Health System and School of Medicine, Philadelphia, Pennsylvania, USA.
Lichtenstein
G R
GR
D000328:Adult; D000368:Aged; D001630:Bezoars / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003937:Diagnosis, Differential; D019160:Endosonography; D017809:Fatal Outcome; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000000981:diagnostic imaging* / Q000473:pathology; D013396:Suction / Q000379:methods*