title: Endoscopic balloon dilatation of benign gastric outlet obstruction.
abstract: OBJECTIVE
  Endoscopic balloon dilatation (EBD) has been used for the treatment of gastric outlet obstruction (GOO). There are several reports on the utility and success of this non-surgical treatment option in peptic GOO, with variable results. However, there are only a few reports documenting the efficacy of this method for non-peptic GOO. The authors here report on experience with balloon dilatation in peptic and non-peptic GOO over a 3-year period.
  
  
  METHODS
  Twenty-three patients with benign GOO underwent EBD. Dilatation was carried out with through-the-scope balloon dilators after premedication. Dilatation was repeated every week and the response was documented on the basis of symptoms and endoscopic findings and barium studies. Helicobacter pylori was eradicated in patients with peptic GOO, when present.
  
  
  RESULTS
  The 23 patients with GOO included 11 with peptic ulcer as the etiology, eight with corrosive-induced and four with chronic pancreatitis (alcohol three, idiopathic one). Patients with peptic GOO required 1-3 sessions (mean 2.0 +/- 0.63) to achieve a diameter of 15 mm dilatation, with uniformly good response over a mean follow-up period of 14.04 +/- 9.79 months. Corrosive-induced GOO required a larger number of dilatation sessions (2-9, mean 5.63 +/- 2.88), but the response was equally good, with follow up of 12-30 months. Patients with pancreatitis-related GOO, however, failed to respond despite a mean of 5.50 (+/-0.58) dilatations, and continued to have symptoms. All these patients were subjected to surgical bypass. There were no major complications such as perforation.
  
  
  CONCLUSIONS
  A good response can be expected in the majority of patients with peptic and corrosive-related GOO after balloon dilatation; however, poor results are noted for chronic pancreatitis-related GOO.
authors.affiliation: Clinical section, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dr_kochhar@hotmail.com
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.forename: Pradeepta Kumar
authors.initials: PK
authors.lastname: Sethy
authors.forename: Birender
authors.initials: B
authors.lastname: Nagi
authors.forename: Jay Dev
authors.initials: JD
authors.lastname: Wig
mesh_terms: D000328:Adult; D000368:Aged; D001464:Barium; D002404:Catheterization; D002424:Caustics / Q000506:poisoning; D002908:Chronic Disease; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications; D010437:Peptic Ulcer / Q000150:complications; D011859:Radiography; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002424:Caustics; D001464:Barium