Double-balloon endoscopy: past, present, and future.

Area of Science:

• Gastroenterology
• Endoscopy
• Small Intestine Diseases

Background:

• The small intestine presents diagnostic and therapeutic challenges due to its length and anatomy.
• Double-balloon endoscopy (DBE) was developed to overcome these limitations.

Purpose of the Study:

• To review the diagnostic and therapeutic applications of double-balloon endoscopy (DBE) in the entire small intestine.
• To highlight DBE's utility in managing small bowel tumors, inflammatory diseases, and strictures.

Main Methods:

• DBE utilizes a soft overtube with a balloon to facilitate deep small bowel intubation.
• Biopsies, endoscopic therapies (hemostasis, polypectomy, dilation), and specialized procedures like ERCP in Roux-en-Y patients are performed.

Main Results:

• DBE allows for accurate localization of ulcers for differential diagnosis of inflammatory conditions.
• Therapeutic interventions, including tumor biopsy and stricture dilation, are feasible.
• DBE is effective for difficult colonoscopies and endoscopic submucosal dissection.

Conclusions:

• DBE is a versatile tool for small intestine diagnosis and therapy, including complex cases and biliary interventions.
• Careful technique is crucial to minimize complications due to the thin small intestinal wall.
• Future advancements in maneuverability and imaging will further enhance DBE's capabilities.