Single-balloon enteroscopy: results from an initial experience at a U.S. tertiary-care center

Abstract

Background Single Balloon Enteroscopy (SBE) is a novel deep enteroscopy modality for diagnosis and treatment of disorders of the small bowel. Objective The aim of the study was to examine the performance, yield and safety of SBE in the initial experience at a tertiary care center. Design Retrospective analysis of all SBEs during a 10 month period in 2008. Data was extracted from electronic clinical and endoscopy records. Setting U.S. tertiary care center. Patients All patients referred for SBE were included in the current analysis. Intervention SBE. Main Outcome Measurements Anterograde SBE procedure time, diagnostic yield, and complications. Results Thirty-eight anterograde SBEs were performed. The mean age was 62 (42% female). Patients (97%) were referred for gastrointestinal bleeding, Crohn's disease, suspected polyps or neoplasia, and abnormal capsule endoscopy. The mean procedure time was 49 ± 19 minutes. The estimated depth of insertion: proximal jejunum (34%), mid-jejunum (45%), distal jejunum (21%). The SBE diagnostic yield was 47%, with significant findings in 18 patients. Findings included: angiectasias, bleeding, abnormal mucosa, ulceration, polyps, and foreign body. The therapeutic yield was 42%, with lesion ablation performed in 24%. Diagnostic biopsies were performed in 24% of subjects, and tattooing in 52%. There were no significant complications. Limitations Single center retrospective study. Conclusions Single balloon enteroscopy appears to be a safe and efficient method for examination of the mid-small bowel. The significant therapeutic yield (42%) suggests comparative studies with double balloon and spiral enteroscopy are warranted.

The safety and efficacy of single balloon enteroscopy in the elderly

“…All three older groups had higher therapeutic yields compared with our control group. This is consistent with other studies reporting therapeutic yields of 42-48% in the general population for SBE and is also comparable with a reported therapeutic yield of 46.8% for DBE in the elderly [Frantz et al 2010;Upchurch et al 2010;May et al 2010;Hedge et al 2010].…”

“…Angioectasias were the most common finding on SBE, which is consistent with previous reports on SBE in the general population [Frantz et al 2010;Upchurch et al 2010;Ramchandani et al 2009;Riccioni et al 2011;May et al 2010;Sethi et al 2014;Parikh et al 2013]. Angioectasias are also more common in the elderly comparable with the data with DBE [Hedge et al 2010;Byeon et al 2012].…”

“…Our diagnostic yield in the elderly was higher compared with previous studies for SBE at 66.3% and reached statistical significance in comparison with the control group at 55.6%. Previous studies performed on SBE in all age groups report diagnostic yields ranging from 40.7% to 60% [Frantz et al 2010;Upchurch et al 2010;Ramchandani et al 2009;Kawamura et al 2008;May et al 2010;Parikh et al 2013]. Our higher diagnostic yield in the elderly patients is most likely due to the higher number of vascular lesions present in the elderly in comparison with the total population.…”

Single-balloon push-and-pull enteroscopy system: does it work? A single-center, 3-year experience

“…Tsujikawa et al [24] evaluated 41 patients using the SBE and found it easy to perform, due to the single balloon, and safe to examine the deep small intestine with useful diagnostic and therapeutic capabilities. Other authors [25][26][27][28] with larger series of patients concluded that SBE demonstrated a high diagnostic yield with the real possibility of useful therapeutic interventions. Furthermore, SBE was demonstrated to be a safe and effective method to explore the small bowel.…”

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation

“…The diagnostic yield for SBE for patient with obscure gastrointestinal bleeding is about 47-77%. [4][5][6] In our institution we use SBE and DBE. This patient directly underwent evaluation with SBE with antegrade approach.…”