Endoscopic balloon dilatation using double-balloon endoscopy is a useful and safe treatment for small intestinal strictures in Crohn's disease.
BACKGROUND
Endoscopic balloon dilatation (EBD) is a therapeutic option for intestinal strictures of Crohn's disease (CD). Double-balloon endoscopy (DBE) enables EBD to be performed even for deep-situated strictures of the small intestine. The aim of this study was to clarify the efficacy and safety of EBD using DBE for small bowel strictures in patients with CD.


METHODS
The subjects comprised 25 patients with CD who underwent EBD using DBE for small intestinal strictures for which a colonoscope or gastrointestinal scope could not be inserted. All subjects had obstructive symptoms due to strictures that were confirmed using small intestinal enteroclysis. They were observed for at least 6 months after the initial EBD. The short-term success rate of EBD using DBE, the complication rate and the long-term outcome were investigated.


RESULTS
This procedure was successful with regard to short-term dilatation in 18 of the 25 CD patients (72%). Long strictures measuring more than 3 cm were seen in six out of seven (85.7%) of the unsuccessful EBD cases, compared with two out of 18 (11.1%) of the successful EBD cases (P=0.001). Complications were encountered in two of the 25 patients (8%). The cumulative surgery-free rate for all the subjects was 83% and 72% at 6 and 12 months, respectively.


CONCLUSIONS
EBD using DBE is a useful and safe procedure for small intestinal short strictures in CD patients. We conclude that this procedure is a therapeutic option that should be attempted before resorting to surgical therapy.
Hirai
Fumihito
F
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan. fuhirai@cis.fukuoka-u.ac.jp
Beppu
Takahiro
T
Sou
Suketo
S
Seki
Takehiko
T
Yao
Kenshi
K
Matsui
Toshiyuki
T
D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology / Q000628:therapy; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D007421:Intestine, Small; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome