Laparotomy and intraoperative enteroscopy for obscure gastrointestinal bleeding before and after the era of video capsule endoscopy and deep enteroscopy: A tertiary center experience

Manatsathit, Wuttiporn; Khrucharoen, Usah; Jensen, Dennis M.; Hines, Oscar J.; Kovacs, Thomas O.; Ohning, Gordon V.; Jutabha, Rome; Ghassemi, Kevin A.; Dulai, Gareth S.; Machicado, Gustavo A.

doi:10.1016/j.amjsurg.2017.05.018

Cited by 13 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common route of IOE was transoral followed by trans-enterotomy. A recent study by Manatsathit W, et al also reported vascular lesions, ulcers and tumors to be the most common lesions detected on IOE [36].…”

Section: Discussionmentioning

confidence: 91%

“…The reported rates of diagnostic and therapeutic yield of IOE are 79.3% (58-100%) and 75.7% (48-94%), respectively [1-10, 16, 36]. The diagnostic yield for obscure GI bleeding after non-diagnostic abdominal imaging has been reported to be 91-100% and after non-diagnostic VCE/DAE varies from 14.2% to 66.7% [1,6,9,36]. Traditionally, the treatment of the lesions detected during IOE were performed surgically.…”

Section: Discussionmentioning

confidence: 99%

“…Another problem of IOE is excessive bowel handling which increases the risk of postoperative ileus. The reported complication rates of IOE vary between 1 and 50% [16,36,37]. According to a combined data of 10 studies involving 309 patients, the overall morbidity rate was 16.8% which included surgical and medical morbidities [37].…”

Section: Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Role of Intraoperative Endoscopy in the Management of Small Bowel Diseases

Gupta¹,

Singh²,

Gupta³

et al. 2021

Endoscopy in Small Bowel Diseases

View full text Add to dashboard Cite

With the advances in the endoscopic technology, most of the small bowel diseases are being diagnosed by capsule endoscopy and device assisted enteroscopy. However, there are many clinical situations such as small bowel obstruction, foreign body impaction were these advanced endoscopic procedures cannot be performed. In such cases, intraoperative endoscopy plays a vital role in the management of these small bowel diseases. Intraoperative endoscopy is also very useful in identification of the site of obscure gastrointestinal bleeding in difficult cases. Moreover, capsule endoscopy and device assisted enteroscopy are expensive procedures and not readily available at all medical centers especially in low income countries. On the other hand, intraoperative endoscopy can be easily performed by conventional gastroscope and colonoscope. In this chapter, we have discussed the indications, techniques, outcomes and complications of intraoperative endoscopy in the current era of deep enteroscopy.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of Intraoperative Endoscopy in the Management of Small Bowel Diseases

Gupta¹,

Singh²,

Gupta³

et al. 2021

Endoscopy in Small Bowel Diseases

View full text Add to dashboard Cite

show abstract

“…Thus, this could explain the high rate of surgery in adults who were not screened at a young age. 23 In our centre, 64% of PJS patients had undergone SB surgery before joining the screening programme. Third, with the mastery of SBP endoscopic polypectomy over the past decade at our centre, more challenging resections of large/difficult polyps were successfully attempted.…”

Section: Discussionmentioning

confidence: 97%

“…Concerning IOE, it has been described as a valuable tool in patients with tumours, Meckel's diverticulum 23 and Obscure gastrointestinal bleeding (OGIB), finding a bleeding source in about 80% of cases. 24 In addition, Edwards et al described how this technique improves polyp clearance without the need for additional enterotomies and may help to reduce the frequency of laparotomies in PJS.…”

Section: Discussionmentioning

confidence: 99%

Small bowel polyp resection using device‐assisted enteroscopy in Peutz‐Jeghers Syndrome: Results of a specialised tertiary care centre

Perrod

Samaha

Pérez-Cuadrado-Robles

et al. 2020

UEG Journal

View full text Add to dashboard Cite

Introduction Enteroscopy resection of small bowel polyps in Peutz-Jeghers syndrome has only been described in small case series. Herein, we aimed to assess the efficacy of enteroscopy resection of small bowel polyps within a specialised tertiary care centre and the impact on intraoperative enteroscopy. Methods This was an observational single-centre study. All adult Peutz-Jeghers syndrome patients followed in the Predisposition Digestive Ile-de-France network who underwent an endoscopic resection of at least one small bowel polyp ≥ 1 cm by enteroscopy between 2002–2015 were included. Small bowel polyps were detected under a dedicated screening programme by previous capsule endoscopy and/or magnetic resonance enterography, performed every 2–3 years. Complete treatment was defined as the absence of polyps ≥ 1 cm after conventional endoscopic resection. Intraoperative enteroscopy or surgical resection were indicated in incomplete treatments. The overall complete treatment rate including conventional enteroscopy and intraoperative enteroscopy was also considered. Results Endoscopic resection of 216 small bowel polyps (median: 8.6 per patient, size: 6–60 mm) was performed by 50 enteroscopies in 25 patients (mean age: 36 years, range: 18–71, 56% male) with small bowel polyp ≥ 1 cm. Twenty-three patients (92%) underwent 42 screening capsule endoscopies and 14 (57%) had 23 magnetic resonance enterographies during a median follow-up of 60 months. Complete treatment was achieved in 76%. Intraoperative enteroscopy and surgical resection were performed in four (16%) and two (8%) patients. Intraoperative enteroscopy improved by 16% the complete treatment rate and the overall rate was 92%. The complication rate was 6%. Conclusion This long-term study confirmed the efficacy and safety of endoscopic resection of small bowel polyps in Peutz-Jeghers syndrome. Intraoperative enteroscopy can be a complementary approach in selected cases.

show abstract

Present role of intraoperative enteroscopy in small bowel bleeding: A tertiary center experience

Huang,

Lin,

Chen

et al. 2023

Adv in Digestive Medicine

View full text Add to dashboard Cite

The aim of this study was to assess the diagnostic yield and outcomes of intraoperative enteroscopy (IOE) in patients with overt small bowel bleeding in the era of balloon‐assisted enteroscopy and capsule endoscopy. We retrospectively reviewed the medical records of patients with small bowel bleeding who underwent IOE from January 2005 to April 2016 in a tertiary medical center. A total of 18 patients with overt small bowel bleeding who underwent a total 18 IOE procedures were included. The mean amount of blood transfusion was 35.7 units (SD, 21.4 units), and 11 patients had hypovolemic shock. The diagnostic yield of the IOE procedures was 94.4% (17/18). The most common pathologic diagnosis was ulcer. The rebleeding rate was 44.4% (8/18), and the overall survival rate was 61.1% (11/18). IOE remains a valuable tool for diagnosing overt small bowel bleeding. The usage of IOE might potentially be limited due to critical clinical conditions in the era of deep enteroscopy. A specific caution should be taken in performing IOE due to the high morbidity of the procedure.

show abstract

Laparotomy and intraoperative enteroscopy for obscure gastrointestinal bleeding before and after the era of video capsule endoscopy and deep enteroscopy: A tertiary center experience

Cited by 13 publications

References 24 publications

Role of Intraoperative Endoscopy in the Management of Small Bowel Diseases

Role of Intraoperative Endoscopy in the Management of Small Bowel Diseases

Small bowel polyp resection using device‐assisted enteroscopy in Peutz‐Jeghers Syndrome: Results of a specialised tertiary care centre

Present role of intraoperative enteroscopy in small bowel bleeding: A tertiary center experience

Contact Info

Product

Resources

About