Endoscopy 2021; 53(S 01): S102-S103
DOI: 10.1055/s-0041-1724519
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An Evaluation of Outcomes Following Endoscopic Balloon Dilatation of Strictures in Crohn’S Disease Patients in a Tertiary Irish Hospital

C Walker
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
A Carroll
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
E McKearney
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
C Deane
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
N Breslin
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
D McNamara
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
S O’Donnell
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
B Ryan
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
,
A O’Connor
1   Tallaght University Hospital, Gastroenterology Department, Tallaght, Dublin, Ireland
› Author Affiliations
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Aims To evaluate outcomes following endoscopic balloon dilatation (EBD) of strictures in patients with Crohn’s disease (CD).

Methods A retrospective study of 45 EBDs on 23 patients. Details about the stricture and dilatation were obtained from endoscopy reports. Charts were reviewed for information about re-admission, escalation of medical therapy, repeat EBD, and surgery.

Results 98 % of EBDs were successful without complications. One failed due to inability to pass the guidewire. Within 30 days of EBD, 9 % were admitted, three for management of flares and one for C.difficile infection.

Tab. 1

Outcomes Following EBD

No Further Intervention

Repeat Dilatation

Surgery

Year 1

68 %

12 %

20 %

Year 3

42 %

29 %

29 %

Year 5

28 %

28 %

44 %

The range of diameter of dilatation was 8–20mm. The median was 15mm. In dilatations >15mm 50 % required surgery, and <15mm 35 % required surgery. When EBD was applied to anastomotic strictures, 33 % required surgery, compared to 45 % in native strictures.

Triamcinolone was used in 9 % of EBDs - 4 % of first dilatations and 17 % of repeat dilatations. Where medical therapy was escalated within 12 months of EBD, reflecting active disease, 50 % avoided surgery.

Conclusions EBD of strictures in CD is a safe treatment which can delay and reduce the need for surgery. Following EBD, 56 % of patients did not require surgical intervention at 5 years. As studies suggest, EBD of anastomotic strictures yielded a better response than when applied to native strictures. However contrary to other studies, surgical intervention was less frequent following EBD with a smaller balloon diameter. Further determination of predictors of positive outcomes would allow for more selective application of EBD.

Citation: Walker C, Carroll A, McKearney E et al. eP18 AN EVALUATION OF OUTCOMES FOLLOWING ENDOSCOPIC BALLOON DILATATION OF STRICTURES IN CROHN’S DISEASE PATIENTS IN A TERTIARY IRISH HOSPITAL. Endoscopy 2021; 53: S102.



Publication History

Article published online:
19 March 2021

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