Endoscopy 2019; 51(04): S80
DOI: 10.1055/s-0039-1681404
ESGE Days 2019 oral presentations
Friday, April 5, 2019 17:00 – 18:30: IBD Club A
Georg Thieme Verlag KG Stuttgart · New York

OUTCOME OF ENDOSCOPIC BALLOON DILATATION FOR SMALL BOWEL STRICTURES USING SINGLE-BALLOON ENTEROSCOPY IN PATIENTS WITH CROHN'S DISEASE

SN Hong
1   Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
,
MJI Goh
1   Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
,
ER Kim
1   Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
,
DK Chang
1   Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
,
YH Kim
1   Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Long standing and relapsing nature of CD, frequent surgeries should be avoided in order to reduce the risk of short bowel syndrome. Endoscopic balloon dilatation (EBD) in CD is minimally invasive bowel-length preserving method. Although most of strictures in CD were occurred in small bowels, a few small studies for the balloon-assisted enteroscopic balloon dilatation for small bowel strictures in patients with CD was reported. We evaluated the outcome of EBD for small bowel strictures using single-balloon enteroscopy (SBE) in patients with CD.

Methods:

This retrospective cohort study was performed on the patients who underwent EBD for small bowel strictures using SBE in patients with CD between 2013 and 2018 in the Samsung Medical Center, Seoul, Korea. A total of 30 consecutive patients with 66 procedures were included and analyzed. Retrograde approach was 54 procedures and antegrade approach was 12 procedures.

Results:

The median follow-up duration was 8.9 (IQR, 3.4 to 20.1) months. Of the enrolled patients, failure to dilate all identified stenosis occurred in 9 patients [failure to reach (n = 4), stricture with deep ulceration (n = 3), acute angulation and tight stenosis (n = 2)]. During follow-up, nine patients were undergone subsequent surgery for bowel obstruction (30%). Cumulative surgery-free rates at 6 months, 12 months, and 60 months were 81.3%, 64.4%, and 42.9%, respectively. Estimated median surgery-free duration was 46.2 (IQR, 36.2 – 56.2) months in patients with technically successful dilation of all identified stenosis and 16.3 (IQR, 3.2 – 29.3) months in patients with failure to dilate all identified stenosis. On the cox regression, length of stricture ≥2 cm was a factor contributing to the success of EBD (HR, 8.6, 95% CI, 1.7 – 43.2, p= 0.009).

Conclusions:

EBD using SBE for small bowel CD strictures was effective in case with the length of stricture < 2 cm.