Long-term Efficacy of Endoscopic Balloon Dilatation in Patients with Small bowel Strictures Secondary to Crohn’s Disease

Abstract Purpose Long-term Efficacy of Endoscopic Balloon Dilatation in Patients with Small bowel Strictures Secondary to Crohn’s Disease were poorly understood. Methods We retrospectively collected and analyzed clinical data of CD patients with small intestinal strictures that underwent EBD treatment at three medical centers. Results A total of 65 patients were included in the present study. During a median follow-up time of 869 days, the overall cumulative rate of repeat intervention after initial EBD was 35.4% (n = 23), with the majority (73.5%) occurring within 3 months. Only CRP level and diameter of dilatation balloon were found to be independently associated with repeat intervention, with HRs of 1.171 (95% CI: 1.040-1.319, p = 0.009) and 0.084 (95% CI: 0.014-0.508, p = 0.007), respectively. There was a tendency for anastomotic cases to have a lower risk of repeat intervention after initial EBD compared to non-anastomotic cases and ileocecal valve cases (p = 0.052). More importantly, the median intervention-free survival (IFS) of the anastomotic group was 1756.50 days (95% CI: 1588.03-1924.98 days), which was significantly longer than the non-anastomotic group (1093.91 days, 95% CI: 692.21-1495.61 days, p = 0.044) and the ileocecal valve group (1175.59 days, 95% CI: 786.96-1564.23 days, p = 0.029). Conclusion In CD patients with small intestinal strictures treated with EBD, overall long-term efficacy was promising, while short-term failure and the requirement of repeat intervention occurred in a subset of individuals. Lower CRP levels and larger balloon sizes were found to be associated with a lower risk of repeat intervention.