Outcomes of pyloroplasty and pyloric dilatation in children diagnosed with nonobstructive delayed gastric emptying.
BACKGROUND
Pyloroplasty and pyloric dilatation are methods used to ameliorate the symptoms of nonobstructive delayed gastric emptying in children. Our purpose was to review the results of these methods with respect to symptomatic improvements.


METHODS
We retrospectively reviewed the records of children who, exclusive of fundoplications, in the 11-year period before December 31, 2005, had undergone at our institution a Heineke-Mikulicz pyloroplasty (HMP) and/or a fluoroscopically guided balloon pyloric dilatation (FGBD). We recorded evidence of either short- or long-term subjective improvement of symptoms.


RESULTS
Twenty-three children underwent HMP. Five had no prior medical treatment. Of the 23, 3 had no subjective improvement in symptoms. Of the 20 who had subjective evidence of improvement recorded, 13 (56.5%) proved to be long-term and 7 short-term improvement. Eight children had FGBD. All 8 had prior medical treatment that had failed. There were 3 who displayed no subjective evidence of improvement, whereas 5 had subjective evidence of improvement-3 (37.5%) long term and 2 short term.


CONCLUSIONS
Heineke-Mikulicz pyloroplasty and FGBD in this study demonstrated only in limited numbers long-term improvement of symptoms. Efforts to understand more fully gastric emptying and to define those children who should undergo FGBD or HMP are needed.
Jawaid
Wajid
W
Department of Pediatric Surgery, British Columbia Children's Hospital, and the University of British Columbia, Vancouver, BC, Canada V6H 3V4.
Abdalwahab
Ahmed
A
Blair
Geoffrey
G
Skarsgard
Erik
E
Webber
Eric
E
D000293:Adolescent; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D005746:Gastric Emptying; D017219:Gastric Outlet Obstruction / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome