Strictures after gastric surgery: treatment with fluoroscopically guided XXXX .

@entity1 @entity384 @entity254 @entity1084 @entity850
OBJECTIVE: Stricture formation resulting in impedance of gastric emptying is a relatively common complication after gastric surgery that involves @entity254 creation or pyloroplasty. Treatment of the @entity850 with fluoroscopically guided @entity384 avoids further surgery. Accordingly, we report our experience with 32 dilating procedures in 24 consecutive @entity1 who had the postoperative complication of obstruction at a surgically created gastric outlet. MATERIALS AND METHODS: Out of our series of approximately 650 fluoroscopically guided balloon dilatations, 32 procedures were performed on 24 @entity1 with anastomotic strictures or pyloric narrowing after gastric surgery (vertical banded gastroplasty or gastric bypass surgery [n = 15], partial esophagectomy with esophagogastrostomy and pyloroplasty [n = 6], and partial gastrectomy with gastrojejunostomy [n = 3]). The group included 13 @entity1 and 11 @entity1 ranging from 32 to 79 years old (mean, 51 years). Diameters of the balloons chosen ranged from 10 to 20 mm, depending on the size of the surgically created @entity254 or pyloroplasty. Indications for @entity384 were clinical and radiographic evidence of @entity1084 . The procedures were done between 13 days and 10 years (mean, 14 months) after gastric surgery. The result of each procedure was assessed by evaluating clinical outcome (relief or recurrence of symptoms) during the follow-up period of 2 days to 36 months (mean, 8 months) after the procedure. RESULTS: In 17 of the 24 @entity1 , the obstructive symptoms were treated successfully with a single dilatation procedure, and symptoms did not recur during follow-up ranging from 1 to 36 months (mean, 11 months). In the other seven @entity1 , the procedure was considered unsuccessful because the @entity1 experienced recurrent obstruction within 2 days to 13 weeks (mean, 3 weeks) after the initial procedure. In one of these, symptoms were relieved by a second procedure. Repeat dilatations in the other six @entity1 were unsuccessful, and all six eventually required surgical revision for definitive treatment. No complicating perforations were noted as a result of dilatation. CONCLUSION: Our experience shows that fluoroscopically guided @entity384 is a simple and safe technique for treating obstructive symptoms caused by strictures occurring after gastric surgery. In the majority of @entity1 , symptoms are relieved with a single @entity384 , eliminating the need for further surgery. However, @entity1 whose obstructive symptoms recur after the initial @entity384 procedure are less likely to benefit from further dilatations and usually require surgery.
