DILATION OF DIFFICULT GASTROINTESTINAL STRICTURES USING A MODIFIED WIRE-GUIDED TECHNIQUE

We describe here 18 patients with gastrointestinal strictures through which a standard guide wire could not be passed, and which were dilate d using a modified technique. After a 0.035 '' guide wire had been pas sed through a 5-Fr metal-tipped catheter, the narrow strictures were d ilated using a 10-Fr biliary dilator. A modified Savary-Gilliard guide wire (olive-tipped with a hole) was passed over the 0.035 '' guide wi re beyond the stricture. After removing the 0.035 '' guide wire, the s trictures were dilated with Savary-Gilliard dilators passed over the o live-tipped guide wire. Seventeen patients had upper gastrointestinal strictures, acid one had a sigmoid colon stricture. The strictures wer e caused by tumor in two, radiation therapy in six, esophagogastric re section for cancer in five, and a combination of two or more factors i n five patients. The modified technique was successful in 17 patients, without any complications. Adequate symptomatic relief was achieved i n 15 patients.