Table 3.
Practical considerations
Predictors favoring successful dilation[11,22-25] | Symptomatic predominantly fibrotic stricture |
Short (≤ 5 cm) stricture | |
Single straight stricture | |
Stricture distal to the duodenum | |
Anastomotic stricture more favorable than de novo stricture | |
First dilation | |
Lack of a superimposed process contributing to symptoms (e.g., SIBO or IBS) | |
Risk factors for complications[22-25] | Predominantly inflammatory stricture without medical optimization |
Stricture greater than 5 cm | |
Multiple small bowel strictures | |
Strictures caused by extrinsic compression (e.g., adhesions) | |
Fistulization within 5 cm of the area to be dilated | |
Adjacent perforation or intra-abdominal collection | |
Complete small bowel obstruction | |
Tortuous or tethered small bowel or significant stricture angulation | |
Duodenal stricture | |
1Short term outcome[15,18] | 85%-95% (technical success), 70%-80% (clinical response) |
2Long term outcome[15,18] | 32% (year 1 post dilation), 80% (year 5 post dilation) |
3Complication rate[25,45] | 1%-4% |
Short term outcome refers to the time elapsed immediately after the dilation takes place; technical success refers to the ability to successfully complete the dilation; clinical response refers to the symptomatic improvement of the patient immediately following the dilation;
Long term outcome refers to the percentage of patients requiring a repeat intervention;
Complication rate encompasses only major complications requiring urgent intervention such as bleeding, perforation and infection.