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Safety and efficacy of double-balloon enteroscopy in pediatric patients
Naoyuki Nishimura1, Hironori Yamamoto, Tomonori Yano
1Department of Medicine, Jichi Medical University, Tochigi, Japan.
Insights
Double-balloon enteroscopy (DBE) is a safe and effective endoscopic tool for pediatric patients, offering diagnostic and therapeutic benefits for various gastrointestinal conditions. This study highlights its clinical utility in children.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
- Minimally Invasive Procedures
Background:
- Double-balloon enteroscopy (DBE) is increasingly utilized in adult gastroenterology.
- Limited published data exists on the application and outcomes of DBE in pediatric populations.
Purpose of the Study:
- To assess the safety and efficacy of double-balloon enteroscopy (DBE) in pediatric patients.
- To evaluate the clinical utility of DBE for diagnosing and treating various gastrointestinal conditions in children.
Main Methods:
- Retrospective analysis of a database.
- Inclusion of pediatric patients (≤18 years) who underwent DBE between September 2000 and October 2008.
- Review of clinical outcomes, indications, and complications.
Main Results:
- 92 procedures were performed in 48 pediatric patients (median age 12.2 years).
- Common indications included biliary anastomosis strictures post-liver transplant and obscure gastrointestinal bleeding.
- Overall diagnostic yield was 65%, with successful endoscopic therapy in 56% of cholangiography cases. One case of postpolypectomy bleeding occurred; no other major complications were noted.
Conclusions:
- Double-balloon enteroscopy (DBE) demonstrates significant safety and clinical usefulness in the pediatric population.
- DBE is a valuable endoscopic modality for diagnosing and treating complex gastrointestinal issues in children.
- Further multicenter studies are warranted to confirm these findings given the current single-center experience.
Background:
Although double-balloon enteroscopy (DBE) is performed increasingly often in adults, few findings are available on the use of DBE in pediatric patients in the published literature.
Objectives:
The aim of our study was to evaluate the safety and efficacy of DBE in pediatric patients.
Design:
A retrospective database review.
Setting And Patients:
A database analysis was performed on all pediatric patients (18 years old or younger) who underwent DBE at the Jichi Medical University Hospital between September 2000 and October 2008 selected from a total of 825 patients.
Main Outcome Measurements:
Clinical utility and safety of DBE in pediatric patients.
Results:
A total of 92 procedures were performed in 48 patients (27 male, 21 female) with a median age (range) of 12.2 (4-18) years. DBE was performed with the patients under general anesthesia in 43 procedures and under moderate sedation in 49 procedures. The most common indication for DBE was treatment of a stricture of a biliary anastomosis after living-donor liver transplantation with establishment of Roux-en-Y hepaticojejunostomy (23 patients). Endoscopic retrograde cholangiography using DBE was performed, and endoscopic therapy could be performed successfully in 13 (56%) patients. The second most common indication was obscure GI bleeding (10 patients); the lesions responsible for the bleeding were found in 7 (70%) patients. Other indications included surveillance and treatment of hereditary polyposis syndromes (5 patients), abdominal pain (4 patients), and inflammatory bowel disease (2 patients). The overall diagnostic yield was 65% (31 of the 48 patients). Postpolypectomy bleeding occurred in 1 case, but no other complications such as perforation and pancreatitis were observed.
Limitations:
Small number of patients, participation bias, and single center's experience.
Conclusions:
DBE is a safe and clinically useful endoscopic procedure in pediatric patients.
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