Small Bowel Endoscopic Exploration Spanish GI Endoscopy Society Recommendations

Pérez-Cuadrado, Enrique; Pons,; Bordas, JM; González, Beatríz; Llach, J; Menchén, Pedro; Pellicer, F; Rodríguez, S

doi:10.1055/s-0032-1310266

Cited by 7 publications

(2 citation statements)

References 71 publications

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“…1,2 Capsule endoscopy can be used in evaluation, while device-assisted enteroscopy, including single-balloon enteroscopy, double-balloon enteroscopy (DBE), and spiral enteroscopy, is a well-established procedure for the evaluation and treatment of patients with suspected small bowel bleeding. [3][4][5] Capsule endoscopy is suggested as the first-line examination in patients with suspected small bowel bleeding 2,6,7 and is favorable within 48 hours to maximize the diagnostic yield. 8 Device-assisted enteroscopy after a previous positive capsule endoscopy for histopathological diagnosis and hemostasis is the current standard management of patients with suspected small bowel bleeding, and the diagnostic yield of DBE after a positive capsule endoscopy was significantly higher than that after a negative capsule endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Early double-balloon enteroscopy was not related to better clinical outcomes in patients with suspected overt small bowel bleeding

Ye,

Sung,

Chang

et al. 2024

Journal of the Chinese Medical Association

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Background: Device-assisted enteroscopy has been used for over 20 years for the management of patients with suspected small bowel bleeding. Unlike esophagogastroduodenoscopy and colonoscopy, the appropriate timing of enteroscopy is still unknown. In recent guidelines, early enteroscopy is suggested to maximize diagnostic yield and therapeutic yield in patients with suspected small bowel bleeding. However, few studies have identified its influence on clinical outcomes, including mortality or rebleeding rate. We conducted this study to evaluate the influence of the timing of double-balloon enteroscopy on clinical outcomes in patients with suspected small bowel bleeding. Methods: Patients with overt small bowel bleeding who underwent double-balloon enteroscopy from January 2013 to February 2021 were retrospectively reviewed. Patients were categorized into an early enteroscopy group (≤14 days) and a nonearly enteroscopy group (> 14 days). Clinical outcomes, including short-term mortality and rebleeding rate, long-term mortality and rebleeding rate, diagnostic yield and therapeutic yield, were analyzed. Results: A total of 100 patients (mean age, 66.2 years; 53% male) were included, and 44 patients were stratified into the early enteroscopy group. The diagnostic yield, therapeutic yield, mortality, and rebleeding rate were similar between two groups. In multivariate conditional logistic regression analysis, there were no significant differences between two groups regarding the 30-day rebleeding rate (adjusted odds ratio [aOR], 1.43; 95%CI, 0.47-4.33), 90-day rebleeding rate (aOR, 1.18; 95%CI, 0.47-2.94), 30-day mortality rate (aOR, 1.29; 95%CI, 0.21-8.13), 90-day mortality rate (aOR, 1.94; 95%CI, 0.48-7.87) and 90-day bleeding-related mortality (aOR, 2.18; 95%CI, 0.24-19.52). The Kaplan‒Meier survival curve analysis showed that the timing of DBE was not associated with the long-term rebleeding rate or mortality rate (p=0.57 and 0.83, respectively). Conclusion: The timing of enteroscopy did not influence the clinical outcomes, including the short-term mortality rate, short-term rebleeding rate, long-term mortality rate and rebleeding rate, in patients with suspected overt small bowel bleeding.

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Section: Introductionmentioning

confidence: 99%

Early double-balloon enteroscopy was not related to better clinical outcomes in patients with suspected overt small bowel bleeding

Ye,

Sung,

Chang

et al. 2024

Journal of the Chinese Medical Association

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“…DBE is not only exploratory but also a therapeutic technique which after more than fifteen years has even been considered as the “gold standard” technique for the endoscopic exploration of the small bowel. Furthermore, the combination of the endoscopic capsule and DBE has been highlighted as the most effective tool for diagnosis and treatment of diseases affecting the small bowel[ 3 ]. This was openly stated in the “guideline” published by the ESGE in 2008[ 4 , 5 ] and has also been largely reported in the scientific literature.…”

Section: Introductionmentioning

confidence: 99%

Evidences supporting the vascular etiology of post-double balloon enteroscopy pancreatitis: Study in porcine model

Latorre

López-Albors

Soria

et al. 2017

WJG

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Double balloon enteroscopy (DBE) is an endoscopic technique broadly used to diagnose and treat small bowel diseases. Among the associated complications of the oral DBE, post-procedure pancreatitis has taken the most attention due to its gravity and the thought that it might be associated to the technique itself and anatomical features of the pancreas. However, as the etiology has not been clarified yet, this paper aims to review the published literature and adds new results from a porcine animal model. Biochemical markers, histological sections and the vascular perfusion of the pancreas were monitored in the pig during DBE practice. A reduced perfusion of the pancreas and bowel, the presence of defined hypoxic areas and disseminated necrotic zones were found in the pancreatic tissue of pigs. All these evidences contribute to support a vascular distress as the most likely etiology of the post-DBE pancreatitis.

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