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Double-balloon endoscopy: who needs it?

Jakob W Hendel1, Peter Vilmann, Troels Jensen

  • 1Department of Gastroenterology, Gentofte University Hospital, Hellerup, Denmark. jachen01@geh.regionh.dk

Scandinavian Journal of Gastroenterology
|February 13, 2008
PubMed
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Capsule endoscopy (CE) effectively screens patients for double-balloon endoscopy (DBE), reducing the need for DBE by two-thirds. This approach also helps determine the optimal route for DBE in suspected mid-gastrointestinal bleeding cases.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Diagnostic Imaging

Background:

  • Double-balloon endoscopy (DBE) offers complete small bowel visualization and therapy.
  • DBE is resource-intensive, necessitating careful patient selection.
  • Capsule endoscopy (CE) is the primary screening tool for small bowel examination.

Purpose of the Study:

  • To evaluate CE as a screening tool for DBE in patients with suspected mid-gastrointestinal bleeding (MGIB).
  • To assess the diagnostic and therapeutic yield of subsequent DBE procedures.
  • To analyze the impact of CE on the utilization of DBE.

Main Methods:

  • Retrospective evaluation of 83 patients referred for CE due to suspected MGIB.
  • DBE was performed if CE revealed pathology.

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  • Follow-up assessed final diagnosis and symptom resolution.

    • Main Results:

    • CE identified indications for DBE in 31% of patients (26/83).
    • DBE achieved a 77% diagnostic yield and 73% therapeutic yield.
    • Patients without CE-indicated DBE did not require it within 12 months.

    Conclusions:

    • CE serves as an effective screening method for DBE.
    • CE can reduce the need for DBE by approximately two-thirds.
    • CE assists in selecting the appropriate DBE route (oral or anal).