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Endoscopic balloon dilatation for Crohn's strictures of the gastrointestinal tract is feasible

John Gásdal Karstensen1, Jakob Hendel, Peter Vilmann

  • 1Department of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark. johngkarstensen@hotmail.com

Danish Medical Journal
|July 5, 2012
PubMed

Insights

Endoscopic balloon dilatation is a safe alternative to surgery for Crohn´s disease strictures, avoiding surgery in most patients. However, recurrence rates necessitate further procedure optimization.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Inflammatory Bowel Disease

Background:

  • Crohn's disease often leads to gastrointestinal strictures, frequently requiring surgical intervention.
  • Endoscopic balloon dilatation has emerged as a viable non-surgical alternative for managing these strictures.
  • This study reports on the clinical experience with endoscopic dilatation for Crohn's disease-related gastrointestinal strictures.

Purpose of the Study:

  • To evaluate the safety and efficacy of endoscopic balloon dilatation for gastrointestinal strictures in Crohn's disease patients.
  • To assess the rate of recurrence and need for surgery following endoscopic dilatation.
  • To determine the complication rate associated with the procedure.

Main Methods:

  • A retrospective analysis of 23 patients with Crohn's disease and obstructive gastrointestinal symptoms was conducted.
  • Patients underwent endoscopic dilatation between January 2005 and February 2011.
  • Pre-procedure evaluation included barium small-bowel follow-through, MRI, and/or endoscopy.

Main Results:

  • Endoscopic dilatation was performed in 19 of 23 patients (83%).
  • During a mean follow-up of 21 months, 74% of patients experienced relapse, and 26% required surgery.
  • A total of 54 dilatations were performed with a low complication rate of 1.9% (one perforation).

Conclusions:

  • Endoscopic dilatation appears to be a safe procedure for managing obstructive gastrointestinal symptoms in Crohn's disease.
  • The procedure successfully avoided surgery in approximately 75% of patients during the follow-up period.
  • Further optimization is required to reduce the recurrence rate of strictures after endoscopic dilatation.
Abstract

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