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Endoscopic therapy of small-bowel polyps by double-balloon enteroscopy in patients with Peutz-Jeghers syndrome

Hong Gao1, Margot G van Lier, Jan Werner Poley

  • 1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

Gastrointestinal Endoscopy
|March 2, 2010
PubMed

Insights

Double-balloon enteroscopy (DBE) is a safe and effective treatment for managing small-bowel polyps in patients with Peutz-Jeghers syndrome (PJS). This minimally invasive procedure can reduce the need for surgery and prevent complications.

Area of Science:

  • Gastroenterology
  • Medical Genetics
  • Minimally Invasive Surgery

Background:

  • Peutz-Jeghers syndrome (PJS) is an inherited condition causing hamartomatous polyps in the small intestine, leading to complications like intussusception.
  • These polyps pose a significant risk for patients with PJS, often necessitating surgical intervention.

Purpose of the Study:

  • To evaluate the effectiveness and safety of double-balloon enteroscopy (DBE) for detecting and treating small-bowel polyps in PJS patients.
  • To assess DBE's utility in managing PJS-related gastrointestinal polyps, particularly in those with prior abdominal surgeries.

Main Methods:

  • A prospective cohort study was conducted at a tertiary-care referral center.
  • Thirteen patients diagnosed with PJS underwent 29 DBE procedures for polyp detection and endoscopic removal of polyps ≥10 mm.
  • Data collected included polyp characteristics, polypectomy success rates, and short- and long-term complications.

Main Results:

  • All 13 PJS patients had small-bowel polyps, predominantly in the proximal jejunum (94%).
  • A total of 82 polyps (≥10 mm) were detected, with 79 successfully removed endoscopically without immediate complications.
  • During 356 person-months of follow-up, no PJS-related small-intestine polyp complications occurred post-DBE.

Conclusions:

  • DBE is a valuable and safe tool for diagnosing and treating small-bowel polyps in PJS patients.
  • The procedure is effective even in patients with a history of extensive abdominal surgery.
  • DBE may reduce the necessity for laparotomy in managing PJS.
Abstract

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