Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding: An updated meta‐analysis

Abstract

Capsule endoscopy and double balloon enteroscopy provide similar diagnostic yields in patients with OGIB. However, the diagnostic yield of DBE is significantly higher when performed in patients with a positive CE.

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

“…This is consistent with prior studies [1,2] . However, when diagnostic yield was compared by lesion type, we found significant differences between VCE and DBE.…”

“…Studies comparing the relative abilities of VCE and DBE, are based on "diagnostic yield" which refers to the proportion of examinations in which any abnormality is detected. Two recent meta-analyses of studies comparing VCE and DBE have demonstrated comparable diagnostic yields [1,2] . Few studies, however, compared the individual abnormalities detected at VCE with those subsequently confirmed at DBE [9] .…”

“…Non-invasive imaging utilizing video capsule endoscopy (VCE) offers the potential to safely visualize the entire small bowel with a high diagnostic yield [1,2] . It is limited by a lack of therapeutic ability, imprecise localization, failure to reach the colon in all cases and inconsistent visualization of the entire small bowel [3] .…”

Interventional balloon-enteroscopy

“…12 Being more complex to perform, DBE is reserved for those cases in which therapeutic interventions are needed or biopsies have to be taken. 13 Diagnostic sequence of CE before DBE after negative results from upper and lower endoscopy is a cost-effective approach in a wide range of scenarios depending on probability of need of a therapeutic intervention: In a recent study, the breakeven point at which cost per procedure is equalized for CE versus DBE was reached at 79 procedures p.a. for a rate of therapeutic review review enteroscopy of 14%, and 27 for a therapeutic enteroscopy rate of 30%.…”

Large Jejunal Av Malformation With Intestinal Ascariasis Presenting as Obscure Gastrointestinal Bleed.

“…The complete visualization is seen in only 11% of the patients using SBE compared 18% in DBE (Domagk D, 2011).Capsule endoscopy (CE) enables the complete small bowel visualization non-invasively but it has no therapeutic utility. There is no difference in diagnostic yield of CE vs DBE (62% vs 56%, p = 0.16) however, diagnostic yield of DBE improves to 75% if it was performed after a positive CE, whereas it was only 27.5% if the previously performed CE was negative (Jeffrey Kl, 2009, Teshima CW, 2011.…”