INTRODUCTIONSince its introduction in 2001 by Yamamoto [1] , double balloon endoscopy (DBE) has revolutionized both diagnostic and therapeutic small bowel endoscopy [2] . This technique allows (intervention) endoscopy of the complete small bowel (often in two sessions) with the possibility of carrying out interventions; e.g. mucosal biopsy, argon plasma coagulation, snare polypectomy, injection therapy, tattooing, foreign body extraction and balloon dilatation. DBE plays an important role in the diagnosis and treatment of obscure gastrointestinal bleeding [3][4][5][6] , Crohn's disease [7][8][9][10] , celiac disease [11,12] , polyposis syndromes [13] and small bowel tumors. In the series published to date, complications solely related to the diagnostic procedure are rare [14][15][16][17][18] . A recent retrospective multicenter survey indicates a complication rate of 0.8% in diagnostic procedures [16] . In that study, pancreatitis occurred in six of 2362 (0.3%) procedures and contributed to 46% of all complications after diagnostic DBE. Another recent study showed that an asymptomatic rise of serum amylase and lipase levels after antegrade DBE is frequently encountered [19] . Nevertheless, only a few patients develop the clinical picture of post-DBE pancreatitis. The reason for this remains unknown.This article presents an analysis of all DBE-related cases of pancreatitis identified prospectively from a recorded DBE-complication database of 603 procedures in a single center. RESULTS: This is the largest single-center study reporting on post-DBE pancreatitis prospectively. Six patients (1.0%) developed post-DBE pancreatitis, all after antegrade DBE. There was no association with gender, duration of the procedure or type of endoscope. The mean age was 51.9 years (range 25-78). Four patients had severe pancreatitis. Of these, two had inflammatory signs in the body-tail region, one had pancreatitis in the tail region, and the total pancreas was involved in one.
MATERIALS AND METHODS
From
CONCLUSION:The incidence of post-DBE pancreatitis in our series is higher than previously reported. We found no relation with DBE-endoscope type. The inflammatory changes occurred in the body-tail region of the pancreas, suggesting that post-DBE pancreatitis is caused by repetitive mechanical strain on the pancreas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.