Gastric outlet obstruction following surgery for morbid obesity: efficacy of fluoroscopically guided balloon dilation.
OBJECTIVE
To evaluate the efficacy of fluoroscopically guided balloon dilation (FGBD) in patients with symptoms of gastric outlet obstruction following surgery for morbid obesity.


METHODS
Forty-one FGBDs were performed in 28 patients with symptoms of gastric outlet obstruction following gastric restrictive surgery for morbid obesity. The efficacy of FGBD was determined using five end points: (a) no recurring symptoms for an interval of at least 3 months, or recurring symptoms treated either (b) surgically, (c) with endoscopically guided balloon dilation (EGBD), (d) with FGBD, or (e) medically.


RESULTS
Following initial FGBD, 11 of 28 patients (39%) remained asymptomatic during at least 3 months of follow-up. Recurrent dysphagia occurred in 17 patients (60%), who were treated either surgically (n = 3), with EGBD (n = 4), with FGBD (n = 9), or medically (n = 1). Of the nine patients who underwent a second FGBD, two became asymptomatic. The seven patients who remained symptomatic were treated with surgery (n = 3), EGBD (n = 1), or FGBD (n = 3). Of the three patients treated with a third FGBD, one became asymptomatic. Overall, FGBD was effective in 14 (50%) of 28 patients.


CONCLUSIONS
Among patients with symptoms of obstruction following gastric surgery for morbid obesity, 50% experienced relief of symptoms following FGBD.
Vance
Peter L
PL
Department of Radiology, University of Virginia Health System, Lee St, HSC 800170, Charlottesville, VA 22908, USA. delange@virginia.edu
de Lange
Eduard E
EE
Shaffer
Hubert A
HA
Schirmer
Bruce
B
D000328:Adult; D000368:Aged; D002404:Catheterization; D005260:Female; D005471:Fluoroscopy; D015390:Gastric Bypass / Q000009:adverse effects*; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D016896:Treatment Outcome