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Background <p>Postoperative anastomotic luminal obstruction is a rare but clinically significant complication after distal gastrectomy. Endoscopic balloon dilatation (EBD) is a minimally invasive treatment; however, some patients require additional interventions. This study aimed to evaluate the clinical outcomes of EBD for postoperative anastomotic luminal narrowing and to identify predictors associated with treatment failure.</p> Methods <p>We retrospectively reviewed 56 patients who developed anastomotic strictures after distal gastrectomy, and treated with EBD between January 2010 and December 2022 at Asan Medical Center, Seoul, Korea. Clinical data, including patient characteristics, surgical factors, and endoscopic findings, were analyzed. Patients were classified into an EBD-only group and an additional-intervention group (stent insertion or surgery). Univariate and multivariable logistic regression analyses were performed to identify predictors of EBD refractoriness.</p> Results <p>Of the 56 patients, 45 (80.3%) achieved symptom improvement with EBD alone, whereas 11 (19.6%) required additional interventions. Diabetes mellitus and failure of scope passage were more frequent in patients who required additional interventions compared with those treated with EBD alone. Multivariable analysis indicated that only failure of scope passage remained an independent predictor (odds ratio, 16.81; 95% confidence interval, 1.61–411.44; <i>p</i> = 0.030). There was one procedure-related complication, aspiration pneumonia, which improved with conservative treatment.</p> Conclusions <p>EBD is an effective and safe first-line treatment for anastomotic strictures after distal gastrectomy. Failure of scope passage through the anastomosis is a simple yet reliable predictor of EBD refractoriness.</p>

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Clinical outcomes of endoscopic balloon dilatation for postoperative anastomotic stricture after distal gastrectomy

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Jun-young Seo,
  • Hee Kyong Na,
  • Chang Seok Ko,
  • Ji Yong Ahn,
  • Jeong Hoon Lee,
  • Kee Wook Jung,
  • Do Hoon Kim,
  • Kee Don Choi,
  • Ho June Song,
  • Jeong Hwan Yook,
  • Beom Su Kim,
  • Moon-Won Yoo,
  • Gin Hyug Lee,
  • Hwoon-Yong Jung

摘要

Background

Postoperative anastomotic luminal obstruction is a rare but clinically significant complication after distal gastrectomy. Endoscopic balloon dilatation (EBD) is a minimally invasive treatment; however, some patients require additional interventions. This study aimed to evaluate the clinical outcomes of EBD for postoperative anastomotic luminal narrowing and to identify predictors associated with treatment failure.

Methods

We retrospectively reviewed 56 patients who developed anastomotic strictures after distal gastrectomy, and treated with EBD between January 2010 and December 2022 at Asan Medical Center, Seoul, Korea. Clinical data, including patient characteristics, surgical factors, and endoscopic findings, were analyzed. Patients were classified into an EBD-only group and an additional-intervention group (stent insertion or surgery). Univariate and multivariable logistic regression analyses were performed to identify predictors of EBD refractoriness.

Results

Of the 56 patients, 45 (80.3%) achieved symptom improvement with EBD alone, whereas 11 (19.6%) required additional interventions. Diabetes mellitus and failure of scope passage were more frequent in patients who required additional interventions compared with those treated with EBD alone. Multivariable analysis indicated that only failure of scope passage remained an independent predictor (odds ratio, 16.81; 95% confidence interval, 1.61–411.44; p = 0.030). There was one procedure-related complication, aspiration pneumonia, which improved with conservative treatment.

Conclusions

EBD is an effective and safe first-line treatment for anastomotic strictures after distal gastrectomy. Failure of scope passage through the anastomosis is a simple yet reliable predictor of EBD refractoriness.