SYMPTOMATIC DOUBLE-CHANNEL PYLORUS - SUCCESSFUL TREATMENT WITH A BILIARY SPHINCTEROTOME

A patient with a previous vagotomy and pyloroplasty was evaluated for symptoms of gastric outlet obstruction. Endoscopy revealed a thick, fi brous bridge that created a dual-channel pylorus. Symptomatic improvem ent was not achieved with balloon dilatation. Surgery was avoided by d ividing the tissue bridge endoscopically with a sphincterotome. Since reestablishing a normal pyloric aperture, the patient's symptoms have been alleviated. This is the first description of this minimally invas ive technique in the management of a symptomatic double-channel pyloru s.