Utilising Oesophageal Biodegradable Stent in Benign Pyloric Stenosis: Novel Technique

Background: Benign pyloric stenosis in not uncommon problem. Different treatment modalities can be implemented each has its drawbacks. In this present a new technique of placement of biodegradable oesophageal stent for treating gastric outlet obstruction secondary to benign peptic stricture Method: 23 year old lady had long history of gastric outlet obstruction secondary to pyloric stenosis requiring recurrent hospitalisation; she had multiple admissions with repeated endoscopic dilatation which relieves her symptoms of short period. Decision was made of placement of pyloric biodegradable (BD) stent as a salvage treatment prior to resorting to surgery, biodegradable stents are designed for oesophageal placement and the delivery system is short to reach the pylorus in a dilated chronic obstructed stomach. Result: A SX-ELLA oesophageal bio degradable (BD Stent) used to overcome the problem of the short delivery system a novel technique was adopted: A nylon fishing wire was securely tied to the tip of a pyloric dilatation guide wire, under endoscopic guidance the pyloric dilatation guide wire (with the nylon wire attached to its tip) passed through the stenosed area, the dilator placed in the fourth part of the duodenum and the balloon inflated (position checked under fluoroscopy), the balloon was pulled out while inflated to shorten the length between the oesphagogastric junction and the pylorus, the stent then passed over the nylon wire and diploid across the stenosed area (position checked under fluoroscopy). Patient seen in follow up three months post procedure with no sign of gastric outlet obstruction and started putting on weight. Conclusion: This study presents a novel technique of utilising oesophageal BD stent in benign pyloric stenosis. A favourable technical and clinical outcome has been achieved. A larger prospective study is needed to validate such observation.