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Endoscopic balloon dilation for peptic gastroduodenal stenosis with gastric outflow obstruction : effectiveness, durability and early predictors of unsatisfactory outcomes

Zeyara, Adam LU orcid ; Scarfone, Léonie LU ; Jeremiasen, Martin LU ; Falkenback, Dan LU ; Andersson, Bodil LU orcid ; Tingstedt, Bobby LU and Johansson, Jan LU orcid (2026) In BMC Gastroenterology 26. p.1-9
Abstract

BACKGROUND: Peptic gastroduodenal stenosis is a rare but disabling condition causing gastric outlet obstruction. This study aimed to evaluate endoscopic balloon dilation in terms of treatment effectiveness, durability, and identify potential early predictors of unsatisfactory outcomes.

METHODS: We conducted a retrospective cohort study of patients who underwent endoscopic balloon dilation for symptomatic peptic gastroduodenal stenosis at Skåne University Hospital, Lund, Sweden between January 1st, 2003, and December 31st, 2023.

RESULTS: A total of 58 patients were included, with a median follow-up of 9.58 years [IQR 4.38–14.15]. Endoscopic balloon dilation was successful in 50 patients (86.2%), of whom 7 (14%) experienced... (More)

BACKGROUND: Peptic gastroduodenal stenosis is a rare but disabling condition causing gastric outlet obstruction. This study aimed to evaluate endoscopic balloon dilation in terms of treatment effectiveness, durability, and identify potential early predictors of unsatisfactory outcomes.

METHODS: We conducted a retrospective cohort study of patients who underwent endoscopic balloon dilation for symptomatic peptic gastroduodenal stenosis at Skåne University Hospital, Lund, Sweden between January 1st, 2003, and December 31st, 2023.

RESULTS: A total of 58 patients were included, with a median follow-up of 9.58 years [IQR 4.38–14.15]. Endoscopic balloon dilation was successful in 50 patients (86.2%), of whom 7 (14%) experienced symptomatic recurrence that was managed with repeat dilations. Eight patients were classified as non-responders and subsequently underwent surgical treatment. Kaplan–Meier curves identified three distinct response patterns among the responders: fast responders (0–1 months), intermediate responders (1-8 months), and slow responders (8-35 months), roughly corresponding to 1-2 dilations, 3-5 dilations, and 6 or more dilations, respectively. Undergoing more than five dilations had a significantly longer treatment duration and lower treatment effect compared with five or fewer dilations. Moreover, more than five dilations were associated with a significantly increased risk for recurrence (OR = 4.09; 95% CI 1.02–16.40, p = 0.047).

CONCLUSION: Most patients with peptic stenosis causing gastric outflow obstruction can be treated successfully with endoscopic balloon dilation alone. More than five dilations seem to be associated with a prolonged treatment period, lower treatment effect and increased risk for recurrence. These findings suggest that reconsideration of treatment strategy could be considered in patients who fail to improve after five dilations.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Gastroenterology
volume
26
article number
66
pages
1 - 9
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41535789
  • scopus:105028671993
ISSN
1471-230X
DOI
10.1186/s12876-026-04619-6
language
English
LU publication?
yes
id
41164aac-5271-4231-89fe-105c71159b20
date added to LUP
2026-02-06 07:20:01
date last changed
2026-02-07 04:00:55
@article{41164aac-5271-4231-89fe-105c71159b20,
  abstract     = {{<p>BACKGROUND: Peptic gastroduodenal stenosis is a rare but disabling condition causing gastric outlet obstruction. This study aimed to evaluate endoscopic balloon dilation in terms of treatment effectiveness, durability, and identify potential early predictors of unsatisfactory outcomes.</p><p>METHODS: We conducted a retrospective cohort study of patients who underwent endoscopic balloon dilation for symptomatic peptic gastroduodenal stenosis at Skåne University Hospital, Lund, Sweden between January 1st, 2003, and December 31st, 2023.</p><p>RESULTS: A total of 58 patients were included, with a median follow-up of 9.58 years [IQR 4.38–14.15]. Endoscopic balloon dilation was successful in 50 patients (86.2%), of whom 7 (14%) experienced symptomatic recurrence that was managed with repeat dilations. Eight patients were classified as non-responders and subsequently underwent surgical treatment. Kaplan–Meier curves identified three distinct response patterns among the responders: fast responders (0–1 months), intermediate responders (1-8 months), and slow responders (8-35 months), roughly corresponding to 1-2 dilations, 3-5 dilations, and 6 or more dilations, respectively. Undergoing more than five dilations had a significantly longer treatment duration and lower treatment effect compared with five or fewer dilations. Moreover, more than five dilations were associated with a significantly increased risk for recurrence (OR = 4.09; 95% CI 1.02–16.40, p = 0.047).</p><p>CONCLUSION: Most patients with peptic stenosis causing gastric outflow obstruction can be treated successfully with endoscopic balloon dilation alone. More than five dilations seem to be associated with a prolonged treatment period, lower treatment effect and increased risk for recurrence. These findings suggest that reconsideration of treatment strategy could be considered in patients who fail to improve after five dilations.</p>}},
  author       = {{Zeyara, Adam and Scarfone, Léonie and Jeremiasen, Martin and Falkenback, Dan and Andersson, Bodil and Tingstedt, Bobby and Johansson, Jan}},
  issn         = {{1471-230X}},
  language     = {{eng}},
  month        = {{01}},
  pages        = {{1--9}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Gastroenterology}},
  title        = {{Endoscopic balloon dilation for peptic gastroduodenal stenosis with gastric outflow obstruction : effectiveness, durability and early predictors of unsatisfactory outcomes}},
  url          = {{http://dx.doi.org/10.1186/s12876-026-04619-6}},
  doi          = {{10.1186/s12876-026-04619-6}},
  volume       = {{26}},
  year         = {{2026}},
}