Endoscopic therapy of benign pyloric stenosis and gastric outlet obstruction

Abstract

To examine the short and long-term success rates of balloon dilation of pyloric stenosis. Several large studies have demonstrated high rates of success for the relief of symptoms from pyloric stenosis using through-the-scope balloons. These dilating balloons readily increase the diameter of the stenotic pylorus on average from 6 to 16 mm. Patients who require more than two dilations are at high risk of endoscopic failure and the need for surgical intervention. Rapid re-stenosis rates are observed in patients with malignant pyloric obstruction. Since many patients with benign pyloric stenosis have underlying ulcer disease, helicobacter infection is a relatively common finding. Eradication of this infection at the time of balloon dilation will ensure higher long-term success rates. In summary, benign pyloric stenosis can be readily treated with endoscopic balloon dilation and should be the first-line therapy.