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Endoscopic balloon dilation management for benign duodenal stenosis
Vibhu Chittajallu1, Yazan Abu Omar2, C Roberto Simons-Linares3
1Digestive Health Institute, University Hospitals Cleveland, Cleveland, OH, USA. vibhu.chittajallu@uhhospitals.org.
Surgical Endoscopy
|January 9, 2023
Summary
Endoscopic balloon dilation (EBD) effectively treats benign duodenal stenosis (BDS) of various causes. Proton pump inhibitor (PPI) use independently predicts successful EBD outcomes, making it a low-risk initial treatment option.
Area of Science:
- Gastroenterology
- Endoscopy
- Surgical Research
Background:
- Benign duodenal stenosis (BDS) is frequently caused by peptic ulcer disease (PUD).
- Endoscopic balloon dilation (EBD) is the standard initial treatment for BDS.
- Limited literature supports EBD's efficacy for BDS.
Purpose of the Study:
- To investigate the spectrum of causes for benign duodenal stenosis.
- To evaluate the effectiveness of endoscopic balloon dilation for BDS.
- To compare outcomes of EBD for different etiologies of BDS.
Main Methods:
- A cohort study analyzed 86 patients with BDS undergoing EBD between 2002 and 2018.
- Data were collected from a prospectively maintained database at a tertiary academic center.
- Technical and clinical success rates of EBD were compared across etiologies and patient demographics.
Main Results:
- Peptic ulcer disease (PUD) was the most common cause (45.3%), followed by Crohn's disease (22.1%) and idiopathic causes (26.7%).
- Technical success rate was 97.4% and clinical success rate was 77.8% for index dilations.
- Proton pump inhibitor (PPI) usage was associated with a 3.6-fold increase in clinical success (p=0.04).
Conclusions:
- Endoscopic balloon dilation (EBD) demonstrates high technical and clinical success for benign duodenal stenosis (BDS), irrespective of etiology.
- EBD is a low-risk alternative to surgical intervention for initial BDS management.
- Proton pump inhibitor (PPI) use is an independent predictor of clinical success in EBD for BDS.
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