Complications associated with double balloon enteroscopy at nine US centers

Area of Science:

• Gastroenterology
• Endoscopic Procedures

Background:

• Double balloon enteroscopy (DBE) was introduced in the US in 2004.
• Complications like perforation, pancreatitis, and bleeding are known risks of DBE.
• Prevalence and risk factors for DBE complications in the US population were previously undescribed.

Purpose of the Study:

• To describe the prevalence and risk factors of complications associated with Double balloon enteroscopy (DBE) in a US population.
• To analyze complication rates in relation to DBE procedure type and patient surgical history.

Main Methods:

• A retrospective study was conducted across 9 US centers.
• Data from 2478 DBE examinations (anterograde, retrograde, and ERCP-facilitated) performed between 2004 and 2008 were analyzed.
• Complication details, patient history, and surgical anatomy were collected for each case.

Main Results:

• A total of 22 major complications (0.9%) occurred, including 11 perforations (0.4%), 6 pancreatitis (0.2%), and 4 bleeding (0.2%).
• Perforation rates were higher in retrograde DBE (1.1%) compared to anterograde DBE (0.2%) (P = .004).
• Patients with altered surgical anatomy undergoing retrograde DBE had a significantly higher perforation rate (10%) compared to those without (P < .005).

Conclusions:

• Double balloon enteroscopy (DBE) is associated with a higher overall complication rate than standard endoscopic procedures.
• Diagnostic retrograde DBE in patients with altered surgical anatomy presents a significantly elevated risk of perforation.
• Understanding these risks is crucial for patient selection and procedural safety in DBE.