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Balloon pyloroplasty in children with delayed gastric emptying
P L Skarsgard1, G K Blair, G Culham
1Department of Surgery, British Columbia's Children's Hospital, Vancouver.
Insights
Balloon pyloroplasty offers a safe and effective treatment for children with delayed gastric emptying. This minimally invasive procedure improved symptoms and normalized gastric emptying in most patients, with no reported complications.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Procedures
- Gastrointestinal Motility Disorders
Background:
- Delayed gastric emptying (DGE) in children can be refractory to medical management.
- Effective treatment options for pediatric DGE are limited.
- Balloon pyloroplasty presents a potential therapeutic avenue.
Purpose of the Study:
- To assess the initial clinical experience and outcomes of balloon pyloroplasty in pediatric patients with DGE.
- To evaluate the safety and efficacy of this minimally invasive intervention.
Main Methods:
- Retrospective review of seven pediatric patients with scintiscan-proven DGE.
- Patients received balloon pyloroplasty under fluoroscopic guidance, primarily on an outpatient basis.
- Outcomes assessed included symptom resolution, physical findings, gastric emptying normalization, and complications.
Main Results:
- Five of seven children experienced significant symptom improvement or complete resolution after balloon pyloroplasty.
- Post-procedure scintigraphy demonstrated normalized gastric emptying in all four patients who underwent follow-up.
- The procedure was well-tolerated, with no complications reported.
Conclusions:
- Fluoroscopically-guided balloon pyloroplasty is a safe, well-tolerated, and effective initial treatment for pediatric delayed gastric emptying.
- This minimally invasive approach shows promise and warrants further investigation.
- Balloon pyloroplasty can restore normal gastric emptying and alleviate symptoms in pediatric patients.
Objective:
To evaluate initial experience with balloon pyloroplasty for delayed gastric emptying in children.
Design:
A retrospective review.
Setting:
A tertiary care pediatric hospital.
Patients:
Seven children with scintiscan-proven delayed gastric emptying that was refractory to maximal medical therapy.
Interventions:
Balloon pyloroplasty under fluoroscopic guidance, mostly on an outpatient basis. For 1 child, the procedure was endoscopically monitored also.
Outcome Measures:
Postoperative symptoms and physical findings, gastric emptying and complications.
Results:
Of the 7 children who underwent balloon pyloroplasty, 3 were rendered asymptomatic and 2 more were symptomatically improved. Four of the original 7 patients underwent postdilation scintigraphy, and all 4 showed normalization of the gastric emptying time. There were no complications.
Conclusions:
Initial experience with fluoroscopically-guided balloon pyloroplasty indicates that it is a safe and easily tolerated procedure, worthy of further study.