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Endoscopic interventions in the small bowel using double balloon enteroscopy: feasibility and limitations
Andrea May1, Lars Nachbar, Jürgen Pohl
1Department of Internal Medicine II, HSK Wiesbaden, Teaching Hospital of the University of Mainz, Wiesbaden, Germany.
The American Journal of Gastroenterology
|January 16, 2007
Summary
Double-balloon enteroscopy (DBE) enables safe therapeutic interventions deep in the small bowel. While generally successful, polypectomy of large polyps carries the highest risk of complications.
Area of Science:
- Gastroenterology
- Endoscopy
- Small Bowel Diseases
Background:
- Double-balloon enteroscopy (DBE) is an advanced endoscopic tool for diagnosing and treating small bowel diseases.
- Therapeutic interventions in the small bowel present unique challenges compared to the upper and lower GI tract.
Purpose of the Study:
- To evaluate the acute technical success rate of DBE.
- To assess the acute complication rate associated with DBE procedures.
Main Methods:
- 353 patients with suspected or known small bowel disease underwent 635 DBE procedures between June 2003 and July 2006.
- Diagnostic yield was 75% for relevant small bowel lesions; therapeutic yield was 67%.
- Therapeutic interventions, including APC, polypectomy, and dilation, were performed in 139 patients, primarily under conscious sedation.
Main Results:
- A median of 270 cm (oral route) and 150 cm (anal route) of the small bowel were visualized.
- 178 therapeutic procedures were performed, with polypectomy (46) and APC (102) being the most common.
- Acute complications occurred in 3.4% of therapeutic procedures, with bleeding and perforation noted after large polyp removal.
Conclusions:
- DBE allows for safe endoscopic therapeutic interventions in the majority of small bowel disease cases.
- Polypectomy of large polyps (>3 cm) is associated with the highest risk of complications during DBE.
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