Intest Res.  2013 Jan;11(1):34-40. 10.5217/ir.2013.11.1.34.

Double Balloon Enteroscopy in a North American Setting: A Large Single Center 5-year Experience

• Seven G
• Kozarek RA
• Ross A
• Irani S
• Gluck M
• Schembre D
• Koch J
• Gan SI

• KMID: 2054659
• DOI: http://doi.org/10.5217/ir.2013.11.1.34

Abstract

BACKGROUND/AIMS
Double balloon enteroscopy (DBE) allows both diagnosis and therapeutic maneuvers in the small bowel. Its use was pioneered in Europe and Asia but there remains a relative paucity of literature from North America. Our aim in this study was to determine diagnostic and therapeutic yield in a North American setting.
METHODS
A five-year retrospective analysis of all patients undergoing DBE at a single tertiary care North American hospital was performed.
RESULTS
Four-hundred fifty-seven procedures, 265 anterograde and 192 retrograde, were performed on 335 patients. The most common indications were obscure gastrointestinal bleeding, small bowel obstruction, and suspected masses and mucosal abnormalities. Total enteroscopy was achieved in 19 of the 89 patients who had both anterograde and retrograde procedures. Overall diagnostic yield in the determination of cause of symptoms or previous imaging was 52%. The most common causes of obscure bleeding were small bowel ulcers (10%), vascular lesions (25%) and neoplasms (10%). The most common causes of small bowel obstruction were strictures, some of which underwent dilation. Other therapeutic interventions included polypectomy, retrieval of retained capsules, stent retrievals and percutaneous enteral jejunostomy tube placement. Overall complication rates were very low (0.6%) and included medication reaction (n=1), scope dysfunction (n=1) and perforation (n=1).
CONCLUSIONS
DBE can be performed safely and with good diagnostic yield in a single referral center in North America.

Keyword

Intestinal neoplasms; Gastrointestinal hemorrhage; Double balloon enteroscopy; Capsule endoscopy

MeSH Terms

Asia
Capsule Endoscopy
Capsules
Constriction, Pathologic
Double-Balloon Enteroscopy
Europe
Gastrointestinal Hemorrhage
Hemorrhage
Humans
Intestinal Neoplasms
Jejunostomy
North America
Referral and Consultation
Retrospective Studies
Stents
Tertiary Healthcare
Ulcer
Capsules