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Probe-based Confocal Laser Endomicroscopy of the Urinary Tract: The Technique
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Stephan Miehlke1, A Morgner, D Aust

  • 1Center for Digestive Diseases, Cooperation of Internal Medicine, Hamburg, Germany. prof.miehlke@mdz-hamburg.de

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This study shows probe-based confocal laser endomicroscopy (pCLE) is feasible and safe for deep small bowel imaging during double balloon enteroscopy (DBE). The technique successfully visualized mucosal architecture and pathology in 96.3% of cases.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Medical Imaging

Background:

  • Probe-based confocal laser endomicroscopy (pCLE) enables in-vivo assessment of gastrointestinal mucosal architecture.
  • Double balloon enteroscopy (DBE) allows deep insertion into the small bowel.
  • The combination of pCLE with DBE for deep small bowel examination has not been previously investigated.

Purpose of the Study:

  • To investigate the feasibility and safety of performing pCLE during DBE.
  • To assess the technical success rate of pCLE in the deep small bowel.
  • To evaluate the safety profile of the combined pCLE-DBE procedure.

Main Methods:

  • DBE was performed using the Fujinon EN-450P5 system.
  • pCLE was conducted using a 1.8-mm probe (Cellvizio-GI®) after fluorescein injection.
  • Technical success was defined by successful probe advancement and imaging; safety was monitored for adverse events.

Main Results:

  • 27 DBE procedures were performed in 16 patients, reaching mean small bowel insertion depths of 255 cm (antegrade) and 130 cm (retrograde).
  • Technical success for pCLE was high at 96.3% (antegrade 92.8%, retrograde 100%), with one instance of incomplete probe advancement.
  • No adverse events related to pCLE were reported, and small bowel mucosal architecture, including pathological findings, was visualized in all successful procedures.

Conclusions:

  • This study demonstrates the first successful and safe application of pCLE in the deep small bowel via DBE.
  • pCLE during DBE allows for in-vivo visualization of small bowel mucosal architecture and pathology.
  • Further research is warranted to establish the clinical utility of pCLE in managing small bowel diseases.