Changes over time in indications, diagnostic yield, and clinical effects of double-balloon enteroscopy

We performed a retrospective study to investigate changes between different time periods in the indications, diagnostic yield, and clinical impact of double-balloon enteroscopy (DBE).

We analyzed records from the database at Soonchunhyang University College of Medicine from all patients undergoing DBE between September 2004 and May 2011 (181 DBEs, 133 patients). We compared DBE-related factors between the first stage (September 2004-August 2006; 117 DBEs, 79 patients) and second stage (September 2006-May 2011; 64 DBEs, 54 patients) of the study period.

The number of DBEs performed decreased between stages. Obscure gastrointestinal bleeding was the most common indication for DBE during each stage (65.8% vs 50%; P = .06). Abnormalities in other modalities as the second indication increased significantly in the second stage compared with the first (11.4% vs 29.6%; P = .008). Between stages, use of computed tomography increased (53.8% vs 81.5%; P = .001), along with capsule endoscopy (29.1% vs 44.4%; P = .06). Mucosal lesions were the most common finding in each stage (56% and 53.1%; P = .686). The diagnostic yield of DBE was 89.3% in the first stage and 93.9% in the second (P = .384). In the first stage, DBE identified 86.4% of cases that had negative results from other modalities; in the second, it identified all cases (P = .3). Therapeutic plans were determined in 89.7% of patients only on the basis of results from DBE.

Between the time periods of 2004-2006 and 2006-2011, the clinical indications for DBEs and outcomes did not change. However, the selectivity of the number of patients decreased between stages.