Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center

García-Correa, J.J.E.; Ramírez-García, J.J.; García-Contreras, L.F.; Irusteta-Jiménez, Leire; Michel-Espinoza, Luis Rodrigo; Uribe, Ariatna Salazar; Chavez, Juan-Miguel; González-Ojeda, Alejandro

doi:10.1016/j.rgmxen.2017.08.001

Cited by 8 publications

(15 citation statements)

References 26 publications

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“…DBE has been found to be therapeutically beneficial, and overall positive yield was 65 to 82% in recent years. [23][24][25] We could achieve a positive diagnostic and therapeutic yield of 72%. However, this may be due to the smaller number of patients in the current study as well as the presence of active bleeding.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of Double Balloon Enteroscopy for Managing Overt Small Bowel Bleeding

Dalal

Patil

Maydeo

2020

Journal of Digestive Endoscopy

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Abstract Background The commonest therapeutic indications for double balloon enteroscopy (DBE) includes removal of retained video capsules, dilatation of strictures, polypectomy, and managing obscure small bowel bleeding. We review our experience in managing active small bowel bleeding with DBE. Methods A retrospective review was done for all the cases undergoing DBE from August 2017 to July 2019. Patient follow-up data was collected. Results Among 25 cases with a median age of 46.8 (range 25–65 years), 17 males (68%) underwent DBE for suspected small bowel bleeding. The commonest presenting complaint was melena 19 (76%). The findings were positive (diagnostic yield) in 18 (72%) patients with an antegrade approach. Active bleeding was associated with Dieulafoy's lesion (n = 6), gastrointestinal stromal tumors (GIST) (n = 4), jejunal varices (n = 3), angioectasia (n = 3), and ulcer (n = 2), who then underwent successful intervention. The rest of the patients underwent both antegrade and retrograde approach but failed to immediately identify an alternative diagnosis. Mean (standard deviation [SD]) time taken for antegrade enteroscopy was 96.7 (15.3) mins and 67.8 (13.6) mins for retrograde enteroscopy. The median duration between the last bleeding episode and timing of DBE was 9 (range 6–15 hours). No major complications were seen during or immediately postprocedure. Conclusion DBE is useful in identifying and treating active small bowel bleeding. Being invasive and time-intensive, it is easy to miss lesions and, therefore, needs appropriate expertise. DBE does appear to be relatively cheaper, with better patient acceptance and time saving.

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Section: Discussionmentioning

confidence: 97%

Outcomes of Double Balloon Enteroscopy for Managing Overt Small Bowel Bleeding

Dalal

Patil

Maydeo

2020

Journal of Digestive Endoscopy

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“…A nivel local se han publicado, hasta la fecha, una serie de casos de pacientes llevados a enteroscopia de un solo balón (1) y otra de EDB (19) ; asimismo, recientemente se publicó la experiencia específica en hemorragia (20) . La mediana de edad en este estudio fue similar a las series reportadas de EDB (5,(21)(22)(23)(24) .…”

Section: Discussionunclassified

“…La hemorragia digestiva potencial del intestino delgado fue también la indicación más frecuente de EDB en otras series de casos, incluidos los publicados en Latinoamérica (3,5,19,21,22,24,25) y en una revisión que incluyó 66 estudios con 12 823 procedimientos publicados entre 2001 y 2010 (26) . Lo anterior permite definir que es un método para el diagnóstico y tratamiento de esta entidad.…”

Section: Discussionunclassified

Enteroscopia de doble balón: experiencia inicial en un hospital universitario

Ramírez

Pérez

Matamoros

et al. 2021

Rev. colomb. Gastroenterol.

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Introducción: el estudio de intestino delgado es un desafío, motivo de avance médico y de interés. La enteroscopia de doble balón (EDB) permite una visualización directa del intestino delgado. Objetivo: describir indicaciones, características del procedimiento, hallazgos, complicaciones y seguimiento de pacientes llevados a EDB en el Hospital de San José de Bogotá, entre noviembre de 2011 y abril de 2019. Metodología: estudio de serie de casos. Se incluyeron pacientes con indicación clínica o por imágenes diagnósticas sugerentes de lesión a nivel de intestino delgado. Se empleó estadística descriptiva. Resultados: se realizaron 45 enteroscopias a 44 pacientes, con una mediana de edad de 58 años. La principal indicación fue hemorragia digestiva potencial de intestino delgado (53,3 %) y diarrea crónica (11,1 %); fueron más frecuentes los procedimientos por vía anterógrada. La mayoría de los resultados fue normal (46,7 %); entre los hallazgos más frecuentes estuvieron los tumores (11,1 %), enfermedad de Crohn (8,9 %) y úlceras/erosiones (6,7 %). El rendimiento diagnóstico fue 53,3 %, la correlación con la videocápsula endoscópica (VCE) fue 37,5 % y con estudios de imagen, 42,9 %. No se presentaron complicaciones. Se hizo seguimiento al 91,1 % de los pacientes con una mediana de 56 meses y se observó la resolución de síntomas en el 78,1 %. La finalidad de la enteroscopia fue diagnóstica en el 84,4 %. Conclusiones: La EDB es útil en la evaluación del intestino delgado con posibilidad terapéutica. Los resultados son similares a los reportados en la literatura mundial. Si se realiza seguimiento, se puede definir la necesidad de repetición del procedimiento, realización de estudios adicionales u observar resolución de los síntomas.

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“…Mean intubation depth varies with the system used: 239 cm for DBE, 233 cm for SBE and 236 cm for SE in the case of oral intubation, and 130 cm for DBE, 123 cm for SBE and 88 cm for SE in the case of anal intubation. [14][15][16] The robotic endoscope is capable of self-propelling locomotion in the gastrointestinal tract. In 1995, Grundfest et al 17 published the preliminary results of a robotic endoscope based on pneumatic actuators with lighting and imaging capacities.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoworm: A new semi-autonomous enteroscopy device

Sánchez-Díaz

Senent-Cardona

Pons

et al. 2018

Proc Inst Mech Eng H

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Using enteroscopes with therapeutic capacity to explore the small intestine entails certain limitations, including long exploration times, patient discomfort, the need for sedation, a high percentage of incomplete explorations and a long learning curve. This article describes the advances and setbacks encountered in designing the new Endoworm enteroscopy system, a semi-autonomous device consisting of a control unit and three cavities that inflate and deflate in such a way that the bowel retracts over the endoscope. The system can be adapted to any commercial enteroscope. Endoworm was tested in different intestine models: a polymethyl methacrylate rigid tube, an in vitro polyester urethane model, an ex vivo pig model and an in vivo animal model. The general behavior of the prototype was evaluated by experienced medical personnel. The mean distance covered through the lumen was measured in each cycle. The system was found to have excellent performance in the rigid tube and in the in vitro model. The ex vivo tests showed that the behavior depended largely on the mechanical properties of the lumen, while the in vivo experiments suggest that the device will require further modifications to improve its performance.

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Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center

Cited by 8 publications

References 26 publications

Outcomes of Double Balloon Enteroscopy for Managing Overt Small Bowel Bleeding

Outcomes of Double Balloon Enteroscopy for Managing Overt Small Bowel Bleeding

Enteroscopia de doble balón: experiencia inicial en un hospital universitario

Endoworm: A new semi-autonomous enteroscopy device

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