Diagnostic and therapeutic utility of double-balloon enteroscopy for obscure GI bleeding in patients with surgically altered upper GI anatomy

Skinner, Matthew J.; Peter, Shajan; Wilcox, C. Mel; Mönkemüller, Klaus

doi:10.1016/j.gie.2014.02.1034

Cited by 24 publications

(19 citation statements)

References 15 publications

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“…BAE can be advanced deep within the small intestine, where it enables accurate diagnosis and endoscopic treatment through the accessory channel as with conventional endoscopy. As opposed to CE that passes by peristalsis, BAE can be advanced to the afferent limb of the postoperative reconstructed intestine and it can be used even when small bowel stenosis or obstruction is suspected.…”

Section: Commentarymentioning

confidence: 99%

Clinical Practice Guideline for Enteroscopy

Yamamoto

Ogata

Matsumoto

et al. 2017

Digestive Endoscopy

124

157

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Management of small bowel diseases has evolved since the advent of capsule endoscopy (CE) and balloon‐assisted enteroscopy (BAE). One of the most common indications for enteroscopy is obscure gastrointestinal bleeding (OGIB), followed by small bowel stenosis, tumors, and inflammatory bowel disease. Although enteroscopes have been regarded as useful tools, correct guidelines are required to ensure that we manipulate these enteroscopes safely and efficiently in clinical practice. Herein, the Japanese Gastroenterological Endoscopy Society has developed ‘Clinical Practice Guidelines for Enteroscopy’ in collaboration with the Japanese Society of Gastroenterology, the Japanese Gastroenterological Association, and the Japanese Association for Capsule Endoscopy. These guidelines are based on the evidence available until now, but small bowel endoscopy is a relatively new technology, so the guidelines include recommendations based on a consensus reached among experts when the evidence has not been considered sufficient. These guidelines were not designed to be disease‐based, but focus on how we should use small bowel CE and BAE in everyday clinical practice.

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Section: Commentarymentioning

confidence: 99%

Clinical Practice Guideline for Enteroscopy

Yamamoto

Ogata

Matsumoto

et al. 2017

Digestive Endoscopy

124

157

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“…This technique also provides permanent access to the upper gastrointestinal tract allowing repeated ERCP procedures in patients with Roux‐en‐Y gastric bypass. Patients with other intestinal surgical reconstructions also benefit from DAE to diagnose and/or treat lesions in gastrointestinal segments out of reach of conventional endoscopes . In particular, enteral metal stent insertion is now possible with the overtube‐assisted technique also in patients with altered anatomy .…”

Section: New Indications For Daementioning

confidence: 99%

“…Patients with other intestinal surgical reconstructions also benefit from DAE to diagnose and/or treat lesions in gastrointestinal segments out of reach of conventional endoscopes. [40][41][42] In particular, enteral metal stent insertion is now possible with the overtube-assisted technique also in patients with altered anatomy. 43,44 After reaching the malignant intestinal obstruction with the help of DAE, the overtube and a guidewire are left in place while the enteroscope is removed and the metal stent is inserted over the guidewire through the overtube under fluoroscopic control.…”

Section: Dae In Patients With Altered Anatomymentioning

confidence: 99%

Update in enteroscopy: New devices and new indications

Moreels

2017

Digestive Endoscopy

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The present review provides an update of the currently available (proto-) types of device-assisted enteroscopy (DAE). In recent years, newly designed double- and single-balloon enteroscopes have emerged. They aim to improve insertion depth into the small bowel, and they also allow more efficient endoscopic interventions. Nowadays, almost all conventional endoscopic procedures are feasible using DAE, opening the door to new indications. Recently, more data have become available on pediatric DAE, DAE-assisted colonoscopy, and DAE in patients with altered anatomy, including DAE-assisted endoscopic retrograde cholangiopancreatography and direct cholangioscopy. Although new enteroscopes are being developed, few comparative studies are available in order to define which DAE suits best for each indication. It is the duty of the international endoscopy community to set up clinical research projects to provide answers to these open questions.

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“…The American Society for Gastrointestinal Endoscopy recommendation for deep enteroscopy as the initial diagnostic evaluation in post bariatratric surgery patients with OGIB was based on experts’ opinion [ 77 ]. Currently, there is only one case series focused on the efficacy of device assisted enteroscopy to successfully identify and treat lesions related to OGIB in the operated stomach [ 78 ]. More precisely, double balloon enteroscopy identified the responsible for OGIB lesion in 10 of the 12 patients with altered anatomy; in 9 of them the bleeding site was at the anastomosis and in one at the afferent limb.…”

Section: Endoscopy For the Management Of Symptoms And Complicationsmentioning

confidence: 99%

Endoscopy after bariatric surgery

Malli¹,

Sioulas²,

Emmanouil³

et al. 2016

aog

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Obesity is a global epidemic with significant morbidity and mortality. Weight loss results in reduction of health risks and improvement in quality of life, thus representing a goal of paramount importance. Bariatric surgery is the most efficacious choice compared to conservative alternatives including diet, exercise, drugs and behavioral modification to treat obese patients. Following bariatric operations, patients may present with upper gastrointestinal tract complaints that warrant endoscopic evaluation and the various bariatric surgery types are often linked to complications. A subset of these complications necessitates endoscopic interventions for accurate diagnosis and effective, minimal invasive treatment. This review aims to highlight the role of upper gastrointestinal endoscopy in patients who have undergone bariatric surgery to evaluate and potentially treat surgery-related complications and upper gastrointestinal symptoms.

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Diagnostic and therapeutic utility of double-balloon enteroscopy for obscure GI bleeding in patients with surgically altered upper GI anatomy

Cited by 24 publications

References 15 publications

Clinical Practice Guideline for Enteroscopy

Clinical Practice Guideline for Enteroscopy

Update in enteroscopy: New devices and new indications

Endoscopy after bariatric surgery

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