Endoscopy 2021; 53(S 01): S102-S103
DOI: 10.1055/s-0041-1724519
Abstracts | ESGE Days
ESGE Days 2021 Digital poster exhibition

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
› Further Information
Also available at
 
 

    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

    © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved.

    Georg Thieme Verlag KG
    Rüdigerstraße 14, 70469 Stuttgart, Germany