Double-balloon enteroscopy in Ireland in the capsule endoscopy era

Area of Science:

• Gastroenterology
• Endoscopy
• Diagnostic Imaging

Background:

• Double-balloon enteroscopy (DBE) and small bowel capsule endoscopy (SBCE) have transformed small bowel disorder diagnosis and treatment in Ireland.
• The study addresses the optimal utilization of these advanced endoscopic techniques.

Purpose of the Study:

• To evaluate the application of DBE in Ireland.
• To compare the diagnostic yield of DBE with and without preceding SBCE.
• To enhance the efficiency of small bowel endoscopy resource allocation.

Main Methods:

• A retrospective comparative study of DBE procedures across two Irish centers.
• Data collection involved reviewing endoscopy reports, referral letters, radiology reports, and patient charts.
• SBCE database review identified patients who underwent SBCE before DBE.

Main Results:

• 242 DBE procedures were analyzed; 20% had prior SBCE.
• Overall DBE diagnostic yield was 47%.
• DBE with prior SBCE showed a significantly higher diagnostic yield (61%) compared to DBE alone (44%), p < 0.0001.
• SBCE demonstrated a 100% negative predictive value and 74% positive predictive value when compared to DBE findings.

Conclusions:

• Small bowel capsule endoscopy serves as a highly valuable screening tool before double-balloon enteroscopy.
• Prior SBCE significantly increases the diagnostic yield of DBE due to its high negative predictive value.
• This approach optimizes resource utilization for diagnosing small bowel disorders.