The Oklahoma experience with Double Balloon Enteroscopy: first one hundred procedures

Double Balloon Enteroscopy (DBE) is a new technique that allows deep intubation into the small bowel, and has therapeutic capabilities including cauterization, biopsy, and polypectomy, as with standard endoscopes. Its major value is in the diagnosis and treatment of mid-gut bleeding. We report our experience with the first 100 DBE procedures performed in Oklahoma. The majority of our patients were elderly, with vasculopathy, often on antiplatelet agents. Despite this, only 1 patient required post procedure hospitalization. Of 94 procedures performed for GI bleeding, positive findings were present in 55. DBE allowed treatment and or guided therapy in 65% of patients. Usually, DBE confirmed prior video capsule endoscopy. However, capsule endoscopy sometimes identified blood or pathology that DBE could not confirm, and, more importantly, treatable findings occurred in patients with prior negative capsule results. Therefore, one should strongly consider small bowel endoscopy in any patient with significant/or ongoing GI blood loss not explained by EGD or Colonoscopy.