Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine

Sunada, Keijiro; Yamamoto, Hironori; Kita, Hiroto; Yano, Tomonori; Satō, Hiroyuki; Hayashi, Yoshikazu; Miyata, Tomohiko; Sekine, Yutaka; Kuno, Akiko; Iwamoto, Michiko; Ohnishi, Hirohide; Ido, Kenichi; Sugano, Kentaro

doi:10.3748/wjg.v11.i7.1087

Cited by 112 publications

(48 citation statements)

References 22 publications

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“…Balloon dilatation by DBE allowed surgical operations to be avoided in most cases. In agreement with previous reports indicating that endoscopic balloon dilatation through DBE is useful for releasing strictures in the small bowel [30,34], any patient who has a reachable stenosis will clearly and rapidly benefit from balloon dilatation through DBE. Although adverse events such as perforation by endoscopic balloon dilatation for ileocolonic strictures have been reported [35,36], we experienced no major adverse events during this study.…”

Section: Discussionsupporting

confidence: 85%

Roles of double-balloon endoscopy in the diagnosis and treatment of Crohn’s disease: a multicenter experience

et al. 2010

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Section: Discussionsupporting

confidence: 85%

Roles of double-balloon endoscopy in the diagnosis and treatment of Crohn’s disease: a multicenter experience

et al. 2010

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“…The treatment strategy can be based on the condition and the cause of the stenosis. 16 In addition, endoscopic balloon dilation therapy may be possible, depending on the cause of the stenosis. (Fig.…”

Section: Stenotic Lesionsmentioning

confidence: 99%

Double-balloon endoscopy: past, present, and future

Sunada

Yamamoto

2009

J Gastroenterol

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Double-balloon endoscopy (DBE) was developed as a new technique for visualization of and intervention in the entire small intestine. In DBE, the intestinal walls are held apart by a balloon attached to the distal end of a soft overtube. DBE has been reported worldwide to be very useful for not only diagnosis but also endoscopic therapy. Biopsy samples of small intestinal tumors can be obtained using DBE, and the appropriate treatment can be selected before a surgical procedure. For inflammatory diseases, DBE can reveal the localization of ulcers in the lumen (on the mesenteric or antimesenteric side), which is important for differential diagnosis. Some endoscopic therapies such as hemostatic procedures, polypectomy, and dilation therapy for benign strictures can be performed in the same manner as in the large intestine. DBE may also be suitable for colonoscopy for difficult insertion cases and therapeutic procedures such as endoscopic submucosal dissection. Furthermore, a double-balloon endoscope can be selectively inserted into the afferent loop to perform endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anastomosis, allowing various kinds of endoscopic treatments for biliary diseases to be successfully performed. Endoscopic therapy in the small intestine, whose wall is very thin, should be performed with special care to avoid complications such as bleeding and perforation. In the future, improvement is expected in terms of maneuverability, therapeutic capability, and imaging technology such as the addition of a magnifying function and flexible spectral imaging color enhancement. We anticipate that DBE will contribute to the establishment of medical science of the small intestine and to research elucidating the mechanisms of small intestinal diseases.

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“…Nevertheless, although in the majority of cases, patients with strictures identified with radiological examinations were excluded from capsule endoscopy studies, capsule retention occurred in 5%-13% of cases [25,48] . Capsule retention in patients with established Crohn's disease can be managed, and sometimes partially solved, by giving steroids [49] or using DBE (both for capsule retrieval and stricture dilation) [50,51] . In this subset of patients, capsule endoscopy can be considered as a major complication because it often requires surgical intervention.…”

Section: Crohn's Diseasementioning

confidence: 99%

Small bowel capsule endoscopy in 2007: Indications, risks and limitations

Rondonotti¹

2007

WJG

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Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

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Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine

Abstract: Double-balloon enteroscopy is a useful method for the diagnosis and treatment of strictures in the small bowel.

Cited by 112 publications

References 22 publications

Roles of double-balloon endoscopy in the diagnosis and treatment of Crohn’s disease: a multicenter experience

Roles of double-balloon endoscopy in the diagnosis and treatment of Crohn’s disease: a multicenter experience

Double-balloon endoscopy: past, present, and future

Small bowel capsule endoscopy in 2007: Indications, risks and limitations

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