Endoscopic Balloon Dilation for Benign Bilioenteric Stricture: Outcomes and Factors Affecting Recurrence

Benign bilioenteric strictures are a known complication after biliary surgery. While balloon dilation is a common treatment, the long-term effectiveness and recurrence patterns are not fully understood. Prior research has shown that postoperative bile leak and early stricture onset may play roles in recurrence. However, no prior work had resolved the specific factors that influence recurrence within the first year. This gap motivated the need to evaluate the outcomes and recurrence factors after balloon dilation. Understanding these factors could help guide treatment decisions. No prior studies had focused on the combined impact of multiple risk factors. Recurrence rates vary across studies, but the mechanisms remain unclear. This study aimed to address these uncertainties by analyzing a single-center cohort. The goal was to identify which patients might benefit most from additional interventions.

This study aimed to evaluate the effectiveness of endoscopic balloon dilation for treating benign bilioenteric strictures and to identify factors associated with early recurrence. The researchers focused on patients who received balloon dilation as their first treatment. They wanted to determine the rate of recurrence within the first year and the time to recurrence overall. The motivation was to provide a clearer understanding of which patients are at higher risk. This could help clinicians decide when to consider additional treatments. No prior work had combined these factors in a single analysis. The study sought to clarify the role of postoperative complications and stricture timing. The researchers hypothesized that certain clinical features might predict recurrence.

The study used a retrospective design to analyze patients who underwent endoscopic balloon dilation between 2008 and 2017. A total of 55 patients were included in the cohort. Researchers reviewed medical records to extract clinical data and recurrence outcomes. They evaluated the time to recurrence and identified potential risk factors. Multivariate analysis was used to determine which factors were independently associated with recurrence. The study focused on patients who had not received prior interventions for the stricture. The researchers considered variables such as postoperative bile leak and stricture onset timing. They also assessed the presence of intrahepatic stones and balloon dilation characteristics.

The recurrence rate of benign bilioenteric strictures was 52.7% within the study period. Within the first year, 32.7% of patients experienced recurrence. The median time to recurrence was 2.78 years. Multivariate analysis identified four significant factors associated with recurrence within one year. Postoperative bile leak had the highest hazard ratio of 10.94. Stricture onset within six months postoperatively had a hazard ratio of 6.18. The absence of intrahepatic stones was also a risk factor with a hazard ratio of 3.05. The presence of a remaining balloon waist had a hazard ratio of 5.71. Patients with two or more risk factors were significantly more likely to experience recurrence. The median time to recurrence was 0.88 years for these patients.

Endoscopic balloon dilation remains an effective treatment for benign bilioenteric strictures. The study found that patients without recurrence factors had better outcomes. The presence of multiple risk factors was strongly associated with early recurrence. The authors suggest that patients with these factors may need additional treatments. The findings highlight the importance of identifying high-risk patients early. The results support the use of balloon dilation in low-risk cases. The study did not propose new treatment methods or future research directions. The authors emphasized the need for individualized treatment planning.