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Gastric Outlet Obstruction Following Surgery for Morbid Obesity: Efficacy of Fluoroscopically Guided Balloon Dilation¹

¹ From the Departments of Radiology (P.L.V., E.E.d.L., H.A.S.) and Surgery (B.S.), University of Virginia Health System, Lee St, HSC 800170, Charlottesville, VA 22908. From the 1999 RSNA scientific assembly. Received March 19, 2001; revision requested April 23; revision received June 25; accepted July 5. Address correspondence to E.E.d.L. (e-mail: delange @virginia.edu).

PURPOSE: To evaluate the efficacy of fluoroscopically guided balloon dilation (FGBD) in patients with symptoms of gastric outlet obstruction following surgery for morbid obesity.

MATERIALS AND METHODS: Forty-one FGBDs were performed in 28 patients with symptoms of gastric outlet obstruction following gastric restrictive surgery for morbid obesity. The efficacy of FGBD was determined using five end points: (a) no recurring symptoms for an interval of at least 3 months, or recurring symptoms treated either (b) surgically, (c) with endoscopically guided balloon dilation (EGBD), (d) with FGBD, or (e) medically.

RESULTS: Following initial FGBD, 11 of 28 patients (39%) remained asymptomatic during at least 3 months of follow-up. Recurrent dysphagia occurred in 17 patients (60%), who were treated either surgically (n = 3), with EGBD (n = 4), with FGBD (n = 9), or medically (n = 1). Of the nine patients who underwent a second FGBD, two became asymptomatic. The seven patients who remained symptomatic were treated with surgery (n = 3), EGBD (n = 1), or FGBD (n = 3). Of the three patients treated with a third FGBD, one became asymptomatic. Overall, FGBD was effective in 14 (50%) of 28 patients.

CONCLUSION: Among patients with symptoms of obstruction following gastric surgery for morbid obesity, 50% experienced relief of symptoms following FGBD.

Index terms: Gastrointestinal tract, interventional procedures, 729.12168 • Interventional procedures, utilization • Obesity, 48.837 • Stomach, interventional procedures, 729.12168, 729.126 • Stomach, stenosis or obstruction, 729.458

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