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

Latorre, Rafael; López-Albors, Octavio; Soria, Federico; Morcillo, Esther; Esteban, Pilar; Pérez-Cuadrado-Robles, Enrique; Pérez-Cuadrado-Martínez, Enrique

doi:10.3748/wjg.v23.i34.6201

Cited by 5 publications

(6 citation statements)

References 68 publications

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“…No differences were observed between single and double balloon endoscopies in a randomised multicentre trial including 130 patients 79 as well as in two recent meta‐analyses 80,81 . Aetiology has not been defined yet, but the most likely mechanism seems to be related to vascular distress causing a hypoxic state, as supported by the experimental evidence of hypoxic areas and necrotic zones in the pancreatic tissue of pigs 82 …”

Section: Resultsmentioning

confidence: 95%

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Systematic review—pancreatic involvement in inflammatory bowel disease

Massironi

Fanetti

Viganò

et al. 2022

Aliment Pharmacol Ther

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Summary Background Inflammatory bowel disease (IBD) is a chronic inflammatory immune‐mediated disorder of the gut with frequent extra‐intestinal complications. Pancreatic involvement in IBD is not uncommon and comprises a heterogeneous group of conditions, including acute pancreatitis (AP), chronic pancreatitis (CP), autoimmune pancreatitis (AIP) and pancreatic exocrine insufficiency (PEI); however, data on such an association remain sparse and heterogeneous. Method PubMed/MEDLINE and EMBASE databases were searched for studies investigating pancreatic involvement in patients with IBD. Results Four thousand one hundred and twenty‐one records were identified and 547 screened; finally, 124 studies were included in the review. AP is the most frequent pancreatic manifestation in IBD; the majority of AP cases in IBD are due to gallstones and drugs but cases of idiopathic AP are increasingly reported. AIP is a rare disease, but a strong association with IBD has been demonstrated, especially for type 2 and ulcerative colitis. The pathogenetic link between IBD and AIP remains unclear, but an immune‐mediated pathway seems plausible. An association between CP and PEI with IBD has also been suggested, but data are to date scarce and conflicting. Conclusion This is the first systematic review of the association between IBD and pancreatic diseases. Gallstones and drugs should be considered the most probable causes of AP in IBD, with type 2 AIP also being possible.

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Section: Resultsmentioning

confidence: 95%

“…Several studies retrieved in the present systematic review reported other possible causes of AP, represented by duodenal and/or papillary lesions, procedural accidents due to either endoscopic balloons, or endoscopic retrograde cholangiopancreatography (ERCP), and primary sclerosing cholangitis (PSC) 69–89 …”

Section: Resultsmentioning

confidence: 99%

Systematic review—pancreatic involvement in inflammatory bowel disease

Massironi

Fanetti

Viganò

et al. 2022

Aliment Pharmacol Ther

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“…However, the pancreatic body and tail were the main parts affected by pancreatitis, and prolonged me-chanical torsion of the pancreatic body caused by repeated stretching was considered the most appropriate suggestion [17,18]. Based on an experiment using a porcine animal model, Latorre et al suggested that vascular distress is the most likely cause of pancreatitis after DBE [19]. The shared and primary belief noted in the literature is that the increased levels of pancreatic serum enzymes are associated with the technique itself [20 -22].…”

Section: Discussionmentioning

confidence: 99%

Novel ultrathin double-balloon endoscopy for the diagnosis of small-bowel diseases: a multicenter nonrandomized study

et al. 2020

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Background This study aimed to compare the markers of potential pancreatic injury during antegrade double-balloon endoscopy (DBE) using the newly developed ultrathin EN-580XP system and the conventional EN-580T system. Methods Patients who were scheduled for antegrade DBE during daily clinical practice were enrolled. Clinical background, adverse events, and laboratory data of patients were compared between those who underwent endoscopy using the EN-580XP system and those in whom the EN-580T system was used. The primary end points were pancreatic hyperamylasemia and hyperlipasemia after DBE. Results A total of 295 cases were registered. Pancreatic hyperamylasemia occurred in 2 of 92 patients (2.2 %) in the EN-580XP group and in 28 of 147 patients (19.1 %) in the EN-580 T diagnosis group (P < 0.001). Hyperlipasemia was significantly different between the two groups (1.1 % [EN-580XP] vs. 13.6 % [EN-580 T diagnosis]; P < 0.001). Acute pancreatitis occurred in four patients (7.1 %) in the EN-580 T therapy group. Multiple logistic regression analyses revealed that the endoscope type EN-580 T was significantly associated with pancreatic hyperamylasemia (adjusted odds ratio [OR] 8.63, 95 % confidence interval [CI] 1.97 – 37.70; P < 0.01) and hyperlipasemia (adjusted OR 13.10, 95 %CI 1.70 – 100.70; P = 0.01). Conclusions The EN-580XP system seemed less harmful to the pancreas during antegrade DBE.

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“…Increased levels of one or more pancreatic serum marker (e.g., hyperlipasemia) is very common after an anterograde DBE procedure of long duration, and acute pancreatitis may occur in patients who had abdominal pain when they underwent anterograde DBE. 35 Normally, the amylase level would be checked after a >2-hour procedure using the anterograde approach in our center.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and therapy using double-balloon endoscopy for small bowel disease: experience from a Chinese tertiary hospital

Yin

Zhao

et al. 2020

J Int Med Res

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Objective To evaluate the clinical efficacy of double-balloon endoscopy (DBE) for small bowel disease (SBD). Methods The clinical and endoscopic data of patients who underwent DBE in a Chinese tertiary hospital from January 2006 to December 2019 were retrospectively reviewed. The patients were divided into three groups by age: the young group (<45 years), middle-aged group (45–65 years), and older group (>65 years). Results In total, 1177 patients who underwent 2134 DBE procedures were included. The anterograde and retrograde route was used in 1111 and 1023 procedures, respectively. The most common reason for performing DBE was suspected small bowel bleeding (SSBB) (53.1%), and the most common SBD was Crohn's disease (CD) (18.1%). Hemostasis was the predominant endoscopic therapy (54.3%). The total complication rate was 0.8%. The incidence of CD was highest in the young group, and the incidence of tumors was highest in the older group; these findings were consistent both among the overall patient population and among patients with SSBB. Conclusions DBE is effective and safe for the diagnosis and treatment of SBD and is considered to have great potential as a first-line method for diagnosing SBD.

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

Cited by 5 publications

References 68 publications

Systematic review—pancreatic involvement in inflammatory bowel disease

Systematic review—pancreatic involvement in inflammatory bowel disease

Novel ultrathin double-balloon endoscopy for the diagnosis of small-bowel diseases: a multicenter nonrandomized study

Diagnosis and therapy using double-balloon endoscopy for small bowel disease: experience from a Chinese tertiary hospital

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