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Endoscopic balloon dilatation (EBD) is a standard treatment for intestinal strictures in Crohn’s disease (CD). No evidence-based guidelines exist regarding the balloon diameter or the balloon pressure to be used, with recent studies suggesting the use of a smaller diameter than classically used. We sought to analyze the factors associated with safety and efficacy of EBD in CD strictures, particularly looking at balloon diameter and dilatation pressure. We conducted a monocentric retrospective study of patients who underwent EBD between 2005 and 2020. Our endoscopy department performed EBD in 94 CD patients during the considered period. The mean size of balloon dilatation was 16 mm (±2.5; including 21 patients with balloon &lt;14 mm) and the mean dilatation pressure was 5.3 atm (±1.5). No perforation was observed. Over a median follow-up of 5.6 years, the probability of being operated was 5.4% at 1 year and 10.4% at 3 years. Smaller height (HR = 0.90,  p  = 0.022) and a higher BMI (HR = 1.23,  p  = 0.014) were associated with the risk of operation. The probability of being operated or redilated was 30.1% at 1 year and 52.5% at 3 years. No factor was significantly associated with this risk. The size of the balloon had no impact on outcomes. In this retrospective cohort, including a significant proportion of CD patients dilated with balloon &lt;14 mm, no perforation was observed and the size of the balloon or the dilatation pressure had no impact on the risk of surgery or redilatation.

Factors associated with the efficacy and safety of endoscopic dilatation of symptomatic strictures in Crohn’s disease: a retrospective cohort study