Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial

Takano, Noriyuki; Yamada, Atsuo; Watabe, Hirotsugu; Togo, Goichi; Yamaji, Yutaka; Yoshida, Haruhiko; Kawabe, Takao; Omata, Masao; Koike, Kazuhiko

doi:10.1016/j.gie.2010.10.047

Cited by 174 publications

(141 citation statements)

References 25 publications

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“…The lower completion rate of DBE was due to the DBE technical difficulties, which made the completion rate of DBE lower (5.5%-20%) than that in the previous study [6] . In particularly, it was sometimes difficult for the retrograde DBE to be intubated from the ileocecal valve [7,8] . In this study, two lesions located in the terminal ileum were missed by DBE because of the retrograde endoscope intubation failure.…”

Section: Discussionmentioning

confidence: 99%

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Zhang¹,

Chun-hua²,

Li³

2015

WJG

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AIM:To compare the roles of capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in the diagnosis of obscure small bowel diseases. December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions, fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into: (1) the definite diagnosis (the diagnosis was confirmed at least by one of the biopsy, surgery, pathology or the drug treatment effects with follow-up for at least 3 mo); (2) the possible diagnosis (a possible diagnosis was suggested by CE or DBE, but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and (3) the unclear diagnosis (no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. in the etiologies between CE and DBE was estimated, and the different possible etiologies caused by the age groups were also investigated. METHODS: From June 2009 toRESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers (P = 0.242, Fisher' s test), and small vascular malformations (χ 2 = 1.810, P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However, DBE was better than CE for larger tumors (P = 0.018, Fisher's test) and for diverticular lesions with bleeding ulcers (P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study (including sponge hemangioma, venous hemangioma, and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates (DR) of CE (60.0%, 53/88) and DBE (59.1%, 52/88). However, the etiological diagnostic yield (DY) difference was apparent. The CE diagnostic yield was 42.0% (37/88), and the DBE diagnostic yield was 51.1% (45/88). Furthermore, there were differences among the age groups (χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer (5/6 cases), vascular malformations (22/29 cases), and active bleeding (3/4 cases) appeared more commonly in the patients over 50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group (4/7cases). The over-25-year group accounted for the stromal tumors (10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary. Core t...

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Section: Discussionmentioning

confidence: 99%

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Zhang¹,

Chun-hua²,

Li³

2015

WJG

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“…Rate of complete small bowel investigations seems to be more regularly achievable using doubleballoon rather than the single-balloon technique whereas the therapeutic impact was similar with SBE and DBE [6][7][8]. Complications are reported in less than 5% of procedures and include pancreatitis (< 1%), bleeding, and perforation, with the rate of complications increasing in therapeutic interventions [9].…”

Section: Endoscopic Imaging In Small Bowel Crohn's Diseasementioning

confidence: 99%

Detecting and Managing Small Bowel Crohn’s Disease – Capsule Endoscopy Becoming a First Line Diagnostic Method?

Hausmann¹,

Albert²

2011

J Gastrointest Dig Syst

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Small bowel endoscopy is crucial for diagnosing small bowel Crohn's disease, and capsule endoscopy is complemented by balloon-assisted enteroscopy to take biopsies and by magnetic resonance imaging to visualize enteral and extra-intestinal involvement. Recently, imaging has also become a key instrument to manage Crohn's disease patients. Treatment control is advised for patients who have undergone bowel resections and is increasingly used to testify treatment success in non-operated patients, too. In this review we present the modern imaging methods to diagnose and to manage Crohn's disease with a special focus on the small bowel. Moreover, current knowledge on the impact of diagnostic methods on the patients' outcome is reported.

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“…Mean depth of small bowel insertion of antegrade DBE varies between 200 cm and 360 cm and between 100 and 167 cm for the retrograde route [14][15][16][17][18][19][20]. Few studies report a relatively high complete enteroscopy rate of 57% and 66% [14,21]. The complication rate of DBE is 0.9 to 1.2% [22,23].…”

Section: Introductionmentioning

confidence: 99%

Refractory Anaemia Secondary to Small Bowel Angioectasias - Comparison between Endotherapy Alone versus Combination with Somatostatin Analogues

Zammit

Sidhu

Sanders

2017

JGLD

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Background & Aims: Patients with small bowel angioectasias (SBAs) can be difficult to manage as they are generally elderly with multiple co-morbidities. Angioectasias are multiple and tend to recur. Argon plasma coagulation (APC), despite being a commonly used method to treat these patients has an associated persistent rate of re-bleeding necessitating additional treatment to manage these patients.Methods: All patients with refractory iron deficiency anaemia secondary to SBAs were retrospectively subdivided into two groups. Patients in group 1 were managed with double balloon enteroscopy (DBE) and APC alone and those in group 2 received Lanreotide in addition to DBE and APC.Results: A total of 49 patients were included in this study: group 1: 37 patients (75.5%), group 2: 12 patients (24.5%). All had significant comorbidities and the mean duration of anaemia was 114.3, SD 307.0 months. Significant improvements in haemoglobin (Hb) (11g/L vs 3.2g/L p=0.043), transfusion requirements per month (0.8 vs 4.7 p=0.052) and mean bleeding episodes (1.08 vs 2.6 p=0.032) were demonstrated in group 2 when compared to group 1. One patient developed symptomatic gallstone disease and one patient stopped Lanreotide due to a lack of response.Conclusions: This is the first study comparing endotherapy to a combination of endotherapy and pharmacotherapy. It shows a significantly better outcome in patients receiving a combination of endotherapy and Lanreotide. Lanreotide can be a safe additional treatment in patients not responding to APC alone.Abbreviations: APC: argon plasma coagulation; CE: capsule endoscopy; DBE double balloon enteroscopy; Hb: hemoglobin; OGIB: over gastrointestinal bleeding; SBAs: small bowel angioectasias.

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Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial

Cited by 174 publications

References 25 publications

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Detecting and Managing Small Bowel Crohn’s Disease – Capsule Endoscopy Becoming a First Line Diagnostic Method?

Refractory Anaemia Secondary to Small Bowel Angioectasias - Comparison between Endotherapy Alone versus Combination with Somatostatin Analogues

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