CHARACTERISTICS OF PATIENTS WITH BENIGN GASTRIC OUTLET OBSTRUCTION REQUIRING SURGERY AFTER ENDOSCOPIC BALLOON DILATION

Objectives: The aim of this study is to identify factors that will pre dict which patients with benign gastric outlet obstruction will not re spond to endoscopic balloon dilation, in a long-term observation, Meth ods: Over a 51-month period, 42 patients with benign gastric outlet ob struction received endoscopic balloon dilation, The ''through-the-scop e'' technique with the aid of a guide wire was used for dilation, Fift een factors were analyzed prospectively in 40 patients, Multivariate a nalysis was used to find the independent factors of the failure of tre atment, Results: The median follow-up period was 23 months (range 1-51 months), Twenty-eight (67%) patients achieved sustained improvement, and 14 (33%) patients underwent surgery, The overall symptom-free rate s in 12, 24, 36, and 48 months were 85.3%, 78%, 68.8%, and 68.8%, resp ectively, The independent prognostic factor for failure of treatment w as the need for more than two courses of endoscopic balloon dilation t o relieve symptoms (odds ratio, 6.857; 95% confidence interval, 1,031- 45,606), Conclusions: Endoscopic balloon dilation for the treatment of benign gastric outlet obstructions is an effective alternative to sur gery, Patient who needs more than two courses of endoscopic balloon di lation to relieve symptoms should receive surgery.