Endoscopy 2007; 39(3): 208-215
DOI: 10.1055/s-2007-966190
Original article

© Georg Thieme Verlag KG Stuttgart · New York

A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel diseases

J.  Zhong1 , T.  Ma1 , C.  Zhang1 , B.  Sun1 , S.  Chen1 , Y.  Cao2 , Y.  Wu2
  • 1Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Yong University, Shanghai, China
  • 2Department of Gastroenterology, Central Hospital of Pu Tuo District, Shanghai, China
Further Information

Publication History

submitted 15 May 2006

accepted after revision 16 October 2006

Publication Date:
26 March 2007 (online)

Background and study aims: The diagnostic yield of double-balloon enteroscopy (DBE) is variable, depending on the indication for the investigaton. The aim of this study was to investigate the diagnostic yield of DBE, and impact on subsequent management. Patients and methods: A total of 378 patients with obscure gastrointestinal bleeding, abdominal pain, diarrhea, or small-bowel obstruction were included in this retrospective study. DBE procedures were followed by active treatments, symptomatic treatments, or follow-up without any treatment. A special scoring system was designed for evaluating the severity of gastrointestinal bleeding, and the scores were compared before and after DBE examination. Results: Lesions were detected in 247/378 patients (65.3 %). The diagnostic yields were 80.6 % for obscure gastrointestinal bleeding, 37.7 % for abdominal pain, 36.5 % for diarrhea, and 81.3 % for small-bowel obstruction. In 208/247 patients with a confirmed diagnosis (84.2 %), specific treatments were performed. Symptoms disappeared or improved in 190/208 patients (91.3 %). The mean score (± standard deviation) for the severity of gastrointestinal bleeding in the 154 patients with positive findings before DBE was 6.8 ± 2.2, and this dropped to 1.5 ± 0.5 (P < 0.01) in patients who underwent specific treatments, to 3.6 ± 0.7 (P < 0.05) in patients who received symptomatic relief, and to 3.9 ± 0.9 (P < 0.05) in patients who received no treatment. Conclusions: Double-balloon enteroscopy had high diagnostic yield in patients with obscure gastrointestinal bleeding and obstruction. The results of DBE had a substantial impact on subsequent management decisions.

References

  • 1 Mylonaki M, Fritscher-Ravens A, Swain P. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding.  Gut. 2003;  52 1122-1126
  • 2 Saurin J C, Delvaux M, Vahedi K. et al . Clinical impact of capsule endoscopy compared to push enteroscopy: 1-year follow-up study.  Endoscopy. 2005;  37 318-323
  • 3 May A, Nachbar L, Wardak A. et al . Double-balloon enteroscopy: preliminary experience in patients with obscure gastrointestinal bleeding or chronic abdominal pain.  Endoscopy. 2003;  35 985-991
  • 4 Yamamoto H, Yano T, Kita H. et al . New system of double-balloon enteroscopy for diagnosis and treatment of small-intestinal disorders.  Gastroenterology. 2003;  125 1556-1557
  • 5 Yamamoto H, Sugano K. A new method of enteroscopy: the double balloon method.  Can J Gastroenterol. 2003;  17 273-274
  • 6 Yamamoto H, Kita H, Sunada K. et al . Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases.  Clin Gastroenterol Hepatol. 2004;  2 1010-1016
  • 7 Alan L B, Anita W. Videocapsule endoscopy renders obscure gastrointestinal bleeding no longer obscure.  J Clin Gastroenterol. 2003;  37 303-306
  • 8 Marco P, Renato S, Emanuele R. et al . Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases.  Gastroenterology. 2004;  126 643-653
  • 9 Neu B, Ell C, May A. et al . Capsule endoscopy versus standard tests in influencing management of obscure digestive bleeding: results from a German multicenter trial.  Am J Gastroenterology. 2005;  100 1736-1742
  • 10 Magnano A, Privitera A, Calogero G. et al . The role of capsule endoscopy in the work-up of obscure gastrointestinal bleeding.  Eur J Gastroenterol Hepatol. 2004;  16 403-406
  • 11 Ell C, May A. Capsule status 2004: what is the outcome in bleeding? Are there really additional indications?.  Endoscopy. 2004;  36 1107-1108
  • 12 May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease.  Gastrointest Endosc. 2005;  62 62-70
  • 13 Saurin J C, Delvaux M, Gaudin J L. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy.  Endoscopy. 2003;  35 576-584
  • 14 Kaffes A J, Koo J H, Meredith C. Double-balloon enteroscopy in the diagnosis and the management of small-bowel disease: an initial experience in 40 patients.  Gastrointest Endosc. 2006;  63 81-86

T. Ma, MD

Department of Gastroenterology
Rui Jin Hospital
Shanghai Jiao Tong University

No.197 Rui Jin Er Rd
Shanghai 200025
China

Fax: +86-21-64315951

Email: xmzxmz@gmail.com

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