Experience with Balloon Dilatation in Crohn’s and Non-Crohn’s Benign Small-Bowel Strictures: Is There a Difference?

Abstract EN

Background/Aim.

Endoscopic balloon dilation (EBD) has been effective for small-bowel strictures in patients with Crohn’s disease (CD).

However, its efficacy and indication for small-bowel strictures in non-CD patients have not been established.

This study evaluated the clinical efficacy and safety of EBD for small-bowel strictures in non-CD patients compared with CD patients.

Methods.

Ninety-eight consecutive patients (mean age, 53 years; average observation period, 45 months) with small-bowel strictures diagnosed by double-balloon endoscopy were retrospectively evaluated at Hiroshima University Hospital from August 2003 to April 2017.

The average number of procedures, short-term and long-term EBD success rates, and safety profiles between the non-CD and CD groups were examined.

Results.

Surgery was selected as the initial treatment in 44 cases (45%) (non-CD group, 27 (61%); CD group, 17 (39%)) as EBD is not indicated.

Fourteen non-CD patients had strictures due to malignant tumors, while 13 patients had benign strictures.

Twenty-three patients (non-CD, 12; CD, 11) underwent EBD.

Forty-three EBD procedures were performed for 17 stricture sites (average: 2.5 procedures/site) in non-CD patients and 41 EBD procedures for 18 stricture sites (average: 2.3 procedures/site) in CD patients.

The short-term success rate was 100% (23/23), whereas the long-term success rate was 92% (11/12) in non-CD patients and 82% (9/11) in CD patients.

No significant differences in the surgery-free rate occurred between both groups.

Furthermore, one adverse event, bleeding after EBD, was encountered in the non-CD group (8%, 1/12).

Conclusion.

EBD for small-bowel strictures demonstrated good clinical outcomes in non-CD patients.