Interventional endoscopy in inflammatory bowel disease: a comprehensive review

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Inflammatory Bowel Disease Management

Background:

• Interventional endoscopy is integral to the multidisciplinary care of complex inflammatory bowel disease (IBD).
• It complements medical and surgical treatments, addressing specific complications like strictures, fistulas, and abscesses.

Purpose of the Study:

• To outline the key roles and techniques of interventional IBD (IIBD) procedures.
• To detail the application of various endoscopic therapies for IBD-related complications and other indications.

Main Methods:

• Review of interventional endoscopic techniques for IBD.
• Discussion of therapies including endoscopic balloon dilation, stricturotomy, stenting, fistula/abscess management, and neoplasia resection.

Main Results:

• Endoscopic stricturotomy shows higher long-term efficacy than endoscopic balloon dilation.
• Lumen-apposing metal stents are suitable for short, anastomotic strictures; self-expanding metal stents for long, refractory ones.
• Specific endoscopic techniques are detailed for fistula/abscess management, with limitations noted for certain fistula types.

Conclusions:

• Interventional endoscopy provides diverse therapeutic options for IBD complications, including strictures, fistulas, and abscesses.
• Techniques range from dilation and stenting to drainage and resection, tailored to specific conditions.
• IIBD therapies can serve as a vital bridge between medical and surgical interventions for selected IBD patients.