UNCOVERED self-expanding metal stents (SEMS) and balloon dilation are safe and effective treatments for benign gastric outlet obstruction (GOO); however, SEMS should not be the first choice due to its associated cost and complications. SEMS are generally used to treat malignant GOO, but can be used as an alternative to surgical treatment in benign GOO. A recent study looked at the safety and efficacy of the two methods in treating benign GOO.
Researchers conducted a real-world study at the interventional and gastroenterology department of the First Affiliated Hospital of Zhengzhou University, Henan, China, between September 2019–March 2025. Participants were patients who were admitted for benign GOO, confirmed via CT, oesophagogastroscopy, and/or gastrointestinal series, and treated with either balloon dilation or SEMS placement to dilate strictures. The team compared length of stay, techniques, treatment costs, clinical outcomes, GOO scoring system (GOOSS), and complications for the two methods. A total of 70 patients were enrolled in the study and divided into three groups according to aetiology of stenosis and treatment. Group A included balloon dilation, Group B post-operative stenoses treated with stenting, and Group C benign GOO except for postoperative stenosis and treated with stenting.
Results showed a technical success rate range between 76.5–87.1%. All three groups showed a significant increase in GOOSS, from GOOSS 1 to 3. Group B had the highest incidence of complications (38.7%, p = 0.0141), including three cases of migration (9.7%), six cases of stent restenosis (19.4%), and two cases of stent fracture or obstruction (6.5%), while Group A had the lowest complication rate (8.8%). Group A had the highest clinical cure rate (68.2%) and the lowest hospitalisation costs. There was no statistically significant difference in rate of stricture recurrence, duration of treatment, or number of treatment sessions between the three groups.
The team concluded that both balloon dilation and SEMS are safe and effective treatments for benign GOO, but that the higher cost and complications make SEMS less suitable as a first-line treatment.
Reference
Liu P et al. A real-world study of balloon dilation vs. self-expandable metal stents for benign gastric outlet obstruction. BMC Gastroenterol. 2025;25(1):559.
