Background and Aims

Peptic ulcer disease (PUD)–related gastric outlet obstruction (GOO) is known to respond favorably to endoscopic balloon dilation (EBD). However, data on efficacy of EBD for other etiologies of benign GOO are sparse. We aimed to compare the response of EBD among different etiologies of GOO.

Methods

Records of all patients with benign GOO who underwent EBD at our tertiary-care center between January 1998 and December 2017 were analyzed. Dilation was done by using through-the-scope balloons. Procedural and clinical success of EBD was compared among different etiologies.

Results

A total of 306 patients were evaluated, of whom 264 (mean [± standard deviation] [SD] age 37.89 ± 17.49 years; men 183, women 81) underwent dilation. Etiologically, caustic ingestion was the commonest cause of GOO (53.8%) followed by PUD (26.1%) and medication-induced (8.3%). Overall procedural and clinical success was achieved in 200 (75.7%) and 243 (92.04%) patients, respectively, requiring a mean (± SD) of 2.55 (2.8) and 5.37 (3.9) sessions, respectively. Caustic-induced GOO responded less favorably, requiring a higher number of dilation sessions and having more refractory strictures than other etiologies. Medication-induced GOO performed worse than PUD-related GOO. Of the 264 patients, 9 (3.4%) had perforations during EBD, 3 had contained leaks and were managed conservatively, and 6 underwent successful surgery.

Conclusion

EBD is successful in a majority of patients with benign GOO, with caustic-induced GOO and medication-induced GOO being more difficult than PUD-related GOO.

中文翻译：

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胃出口良性梗阻患者的病因谱及对内镜球囊扩张的反应

背景和目标

消化性溃疡疾病（PUD）相关的胃出口梗阻（GOO）对内窥镜球囊扩张（EBD）有良好的反应。然而，关于EBD对良性GOO的其他病因的功效的数据很少。我们旨在比较GOO不同病因中EBD的反应。

方法

分析了1998年1月至2017年12月期间在我们的三级护理中心接受EBD的所有良性GOO患者的记录。通过使用范围内的气球进行扩张。在不同病因之间比较了EBD的手术和临床成功率。

结果

总共对306例患者进行了评估，其中264例（平均[±标准差] [SD]年龄37.89±17.49岁；男性183岁，女性81岁）接受了扩张手术。从病因上讲，苛性摄入是GOO的最常见原因（53.8％），其次是PUD（26.1％）和药物引起的（8.3％）。总的手术和临床成功率分别达到200（75.7％）和243（92.04％）患者，分别需要2.55（2.8）和5.37（3.9）疗程的平均（±SD）。苛性碱引起的GOO的反应较差，与其他病因相比，需要更多的扩张期和更多的难治性狭窄。药物诱导的GOO表现比PUD相关的GOO差。在264例患者中，有9例（3.4％）在EBD期间穿孔，有3例渗漏并保守治疗，有6例手术成功。

结论

在大多数良性GOO患者中，EBD是成功的，与PUD相关的GOO相比，苛性碱引起的GOO和药物引起的GOO更加困难。