Schmüdderich W, Harloff M, Riemann J F
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen, FRG.
Endoscopy. 1989 Jan;21(1):7-10. doi: 10.1055/s-2007-1012884.
In 9 patients with benign pyloric stenosis, the stenosis was dilated using through-the-scope (TTS) balloon catheters (diameter 1.5 to 1.8 cm), which can be passed through the biopsy channel of a standard fiberscope under direct vision. In all cases, the stenosis was secondary to fibrous changes in peptic ulcer disease. In addition, all patients had active ulcers. All dilatation treatments were primarily successful: the stenoses were opened for the passage of the fiberscope. There were no complications; even with active ulcers there were no side effects. The treatment was followed by immediate symptomatic relief. On prospective evaluation over a period of 7 months (mean), 6 patients remained asymptomatic, 2 patients had to be dilated again for restenosis and have since been asymptomatic for 1 and 12 months, respectively. One patient had to undergo surgery after 7 months for ulcer perforation into the common bile duct. The TTS technique has considerable advantages over the methods requiring a guide wire. This technique with its easy practicability and low incidence of complications may become a valid alternative to surgical procedures if the good initial results can be confirmed in further studies.
在9例良性幽门狭窄患者中，使用经内镜（TTS）球囊导管（直径1.5至1.8厘米）扩张狭窄部位，该导管可在直视下通过标准纤维内镜的活检通道。所有病例中，狭窄均继发于消化性溃疡疾病的纤维性改变。此外，所有患者均有活动性溃疡。所有扩张治疗均初步成功：狭窄部位已打开以便纤维内镜通过。未发生并发症；即使存在活动性溃疡，也未出现副作用。治疗后症状立即缓解。经过平均7个月的前瞻性评估，6例患者无症状，2例患者因再狭窄不得不再次扩张，此后分别无症状1个月和12个月。1例患者在7个月后因溃疡穿孔至胆总管而不得不接受手术。与需要导丝的方法相比，TTS技术具有相当大的优势。如果能在进一步研究中证实良好的初始结果，这种操作简便且并发症发生率低的技术可能成为手术治疗的有效替代方法。
