Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases

Yamamoto, Hironori; Kita, Hiroto; Sunada, Keijiro; Hayashi, Yoshikazu; Satō, Hiroyuki; Yano, Tomonori; Iwamoto, Michiko; Sekine, Yutaka; Miyata, Tomohiko; Kuno, Akiko; Ajibe, Hironari; Ido, Kenichi; Sugano, Kentaro

doi:10.1016/s1542-3565(04)00453-7

Cited by 615 publications

(409 citation statements)

References 15 publications

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“…In the case of DBE, incomplete upper DBE examinations warrant performing the retrograde procedure another day; it is not uncommon that the antegrade procedure takes 90 minutes while the retrograde procedure is an additional 70 minutes. 15,21,22 The willingness of endoscopists to provide DBE will likely depend on reimbursement;…”

Section: Discussionmentioning

confidence: 99%

“…9-12, 25, 26 Despite reports of successful antegrade DBE extending to the colon, retrograde DBE is frequently required to complete the small bowel examination. 22 The antegrade DBE has been reported to have an average insertion length of 250 -350 cm beyond the pylorus. 2, 15, 21 Therefore we assumed that an antegrade DBE was able to extend examination beyond a PE to the distal jejunum; however, the remainder of the small bowel required further evaluation with a retrograde DBE.…”

Section: Test Characteristics Of Strategies Modeled and Prevalence Ofmentioning

confidence: 99%

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Management of Obscure Occult Gastrointestinal Bleeding: A Cost-Minimization Analysis

Somsouk

Gralnek

Inadomi

2008

Clinical Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

Section: Test Characteristics Of Strategies Modeled and Prevalence Ofmentioning

confidence: 99%

Management of Obscure Occult Gastrointestinal Bleeding: A Cost-Minimization Analysis

Somsouk

Gralnek

Inadomi

2008

Clinical Gastroenterology and Hepatology

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“…With the advent of CE [16], it is now possible to examine the entire small intestine without discomfort to the patient and on an ambulatory basis [25]. This method does not, however, permit biopsies and treatment, a limitation that has been overcome by double-balloon enteroscopy [26]. De Palma et al reported the changes found in the mucosa of the small bowel in patients with PTH [27].…”

Section: Discussionmentioning

confidence: 99%

Effect of Portal Hypertension in the Small Bowel: An Endoscopic Approach

et al. 2007

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Background and aim The effects of portal hypertension in the small bowel are largely unknown. The aim of the study was to prospectively assess portal hypertension manifestations in the small bowel. Methods We compared, by performing enteroscopy with capsule endoscopy, the endoscopic findings of 36 patients with portal hypertension, 25 cirrhotic and 11 non-cirrhotic, with 30 controls. Results Varices, defined as distended, tortuous, or saccular veins, and areas of mucosa with a reticulate pattern were significantly more frequent in patients with PTH. These two findings were detected in 26 of the 66 patients (39%), 25 from the group with PTH (69%) and one from the control group (3%) (P \ 0.0001). Among the 25 patients with PTH exhibiting these patterns, 17 were cirrhotic and 8 were non-cirrhotic (P = 0.551). The presence of these endoscopic changes was not related to age, gender, presence of cirrhosis, esophageal or gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, prior esophageal endoscopic treatment, current administration of beta-blockers, or Child-Pugh Class C. More patients with these endoscopic patterns had a previous history of acute digestive bleeding (72% vs. 36%) (P = 0.05). Active bleeding was found in two patients (5.5%). Conclusions The presence of varices or areas of mucosa with a reticulate pattern are manifestations of portal hypertension in the small bowel, found in both cirrhotic and non-cirrhotic patients. The clinical implications of these findings, as regards digestive bleeding, are uncertain, although we documented acute bleeding from the small bowel in two patients (5.5%).

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“…Enteroscopic techniques such as argon plasma coagulation (APC) and endoscopic clipping have been well studied [1][2][3][4][5] . Endoscopic band ligation (EBL) had been used for the treatment of esophageal varices [6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic band ligation for bleeding lesions in the small bowel

Ikeya¹

2014

WJGE

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AIM:To investigate the safety and efficacy of endoscopic band ligation (EBL) for bleeding lesions in the small bowel.METHODS: This is a retrospective study evaluating EBL in six consecutive patients (three males, three females, 46-86 years of age) treated between May 2009 and February 2014: duodenal vascular ectasia; 1, jejunal bleeding diverticulum; 1, ileal Dieulafoy's lesion; 1 and ileal bleeding diverticula; 3. The success of the initial hemostasis was evaluated, and patients were observed for early rebleeding (within 30 d after EBL), and complications such as perforation and abscess formation. Follow-up endoscopies were performed in four patients. RESULTS:Initial hemostasis was successfully achieved with EBL in all six patients. Eversion was not sufficient in four diverticular lesions. Early rebleeding occurred three days after EBL in one ileal diverticulum, and a repeat endoscopy revealed dislodgement of the O-band and ulcer formation at the banded site. This rebleeding was managed conservatively. Late rebleeding occurred in this case (13 and 21 mo after initial EBL), and re-EBL was performed. Follow-up endoscopies revealed scar formation and the disappearance of vascular lesions at the banded site in the case with a duodenal bleeding lesion, and unresolved ileal diverticula in three cases. Surgery or transarterial embolization was not required without any complications during the median follow-up period of 45 (range, 2-83) mo. CONCLUSION:EBL is a safe and effective endoscopic treatment for hemostasis of bleeding lesions in the small bowel.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Endoscopic band ligation; Small bowel; Diverticular hemorrhage; Jejunal bleeding; Ileal bleeding; Therapeutic endoscopy; Hemostasis Core tip: There have been few reports regarding the use of endoscopic band ligation (EBL) for the treatment of bleeding lesions in the small intestine. The present study demonstrates safe and effective use of EBL to treat six patients with small bowel lesions including, duodenal vascular ectasia, ileal Dieulafoy's lesion, and jejunal and ileal bleeding diverticula. Although the bleeding was successfully managed in all patients, those with diverticular bleeding in the small bowel should be closely monitored after an initial EBL.

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Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases

Cited by 615 publications

References 15 publications

Management of Obscure Occult Gastrointestinal Bleeding: A Cost-Minimization Analysis

Management of Obscure Occult Gastrointestinal Bleeding: A Cost-Minimization Analysis

Effect of Portal Hypertension in the Small Bowel: An Endoscopic Approach

Endoscopic band ligation for bleeding lesions in the small bowel

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