Endoscopic pyloromyotomy for congenital pyloric stenosis.

Background: The advent of sophisticated endoscopic devices allows for a variety of procedures heretofore performed surgically. This study describes the results of endoscopic pyloromyotomy for congenital hypertrophic pyloric stenosis (CHPS).

Methods: Ten consecutive infants (7 boys, 3 girls; age range 3-7 weeks), with a diagnosis of CHPS, underwent endoscopic pyloromyotomy while under conscious sedation by using an endoscopic electrosurgical needle knife or a sphincterotome. Incisions were made from the antral to the duodenal side of the pylorus. All procedures except one were performed on an outpatient basis.

Results: No complication was encountered in any patient. All patients began regular feedings as soon as they recovered from the effects of the sedative medication and were discharged on the same day. At follow-up (range 6 months to 2 years), all patients were doing well.

Conclusions: Surgery for CHPS has undergone little change in recent decades except for the advent of the laparoscopic approach. Surgical pyloromyotomy is considered simple, inexpensive, and safe. Endoscopic pyloromyotomy is equally simple, probably less expensive, and it can be performed as an outpatient procedure.