[Balloon dilatation in the management of gastric outlet stenoses: long-term results]

The authors introduced dilatation of postoperative gastric outlet stenoses in 1981 and later in peptic, corrosive and postvagotomic gastric outlet stenoses. They performed gastric outlet stenoses dilatation with balloon catheter 153 times on 66 patients between September 1981-1999. On three of 8 malignant cases--who had dilatation because of recidive inoperable tumor--metal prosthesis implantation had been performed and others underwent surgery. On 58 patients who suffered from benign stenoses 144 balloon catheter dilatation had been done. After dilatation during the follow up time at 39/58 cases (67.2%) there was no need for operation. The stenoses of anastomosis after antrectomy and pyloric preserving pancreatoduodenectomy at 15 cases had been cured by dilatation. At pyloric and bulbus stenoses two third of the patients, 14 from 21 (67%) and at the cases of corrosive gastric outlet stenoses 6 of 17 (35%) had been treated successfully by dilatation. At postvagotomic functional stenoses 80% of the patients were treated successfully by 23 mm diameter balloon catheter. The dilatation has no long-term effect in malignant stenoses so it was used just for diagnosis or in rare inoperable cases for the preparation of prosthesis implantation. After dilatation therapy they detected one case of artery hemorrhage and two cases of perforation. The balloon catheter dilatation of the gastric outlet stenoses is a very important diagnostic and endoscopic therapeutic method which--depending on the cause--makes operation avoidable in 66% (35-100) of the benign stenoses.