Outcomes and safety of double-balloon enteroscopy in small bowel diseases: a single-center experience of 1531 procedures

Wang, Peng; Wang, Yuxin; Yan, Dong; Guo, Jiefang; Fu, Hongyu; Li, Zhao‐Shen; Du, Yiqi

doi:10.1007/s00464-020-07418-6

Cited by 21 publications

(25 citation statements)

References 18 publications

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“…However, DBE can detect lesions missed by CE, 18 so DBE should still be performed in patients with negative results of CE but still highly suspected to have small intestinal lesions. This study showed that the positive detection rate of DBE was 78.7%, higher than that of some other studies, 7,18,19 which may be due to the more skilled and experienced operators in our hospital. After the checking of DBE, six patients developed abdominal pain and pharyngeal discomfort, and two patients developed pancreatitis, but they all recovered and were discharged.…”

Section: Discussioncontrasting

confidence: 72%

“…5,6 DBE has the characteristics of wide field of vision and clear image, and can be used for biopsy, mucosal staining to mark the lesion site, polyps resection, foreign body removal, etc. [7][8][9] However, the checking time of DBE is long, and patients need to be checked under anesthesia; so, the risks and benefits of DBE need to be weighed comprehensively for patients with older age or many underlying diseases. The purpose of this study was to explore the diagnostic value of CE and DBE for patients who were suspected of having SBD, and to make a comparison between the two checking methods, so as to provide help in the diagnosis and treatment of SBD.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Positive Rate and Diagnostic Value of Capsule Endoscopy and Double-Balloon Enteroscopy in Small Bowel Disease: A Retrospective Cohort Analysis

Liao

Deng

2021

Arch Iran Med

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Background: Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have provided great help in the diagnosis and treatment of small bowel diseases (SBD). The aim of this study was to explore the positive rate and diagnostic value of CE and DBE for patients who were suspected of having SBD, and to make a comparison between the two methods. Methods: A retrospective study was conducted to analyze the cases at Renmin Hospital of Wuhan University. We divided the patients into CE and DBE group, and recorded the basic characteristics of the patients, checking the results of CE and DBE, positive rate, sensitivity and specificity for statistical analysis. Results: A total of 244 patients were included in our research, including 122 in the CE group and 122 in the DBE group. The positive rate of CE for intestinal diseases was 84.4%, higher than that of DBE (78.7%), but DBE (75.2% and 92.3%) had higher sensitivity and specificity than CE (70.5% and 88.2%), though the differences were not statistically significant. The three most common positive findings in patients were inflammation, erosion, or ulcers (28.7%), vascular malformations (14.3%), and eminence lesions (9.0%). CE had a higher rate detection of inflammation, erosion, or ulcers than DBE (36.1% vs 21.3%), but they both had high positive rates for vascular malformations (13.9% and 14.8%). In addition, both methods had higher positive rates in patients with gastrointestinal bleeding compared to other symptoms. Conclusion: CE and DBE are both important methods for intestinal examination. Patients can choose appropriate tests according to their condition.

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Section: Discussioncontrasting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Comparison of the Positive Rate and Diagnostic Value of Capsule Endoscopy and Double-Balloon Enteroscopy in Small Bowel Disease: A Retrospective Cohort Analysis

Liao

Deng

2021

Arch Iran Med

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“…Double balloon enteroscopy (DBE) allows for detailed and direct visualisation and assessment (diagnostic) of the small bowel and application of endoscopic intervention. The risk of PPB associated with DBE is 0.5%, but increases with therapeutic intervention[ 8 , 9 ]. The study by Wang et al [ 9 ] recorded seven episodes of PPB in 1531 DBEs (0.5%), with all associated with therapeutic polypectomy .…”

Section: Diagnostic Endoscopic Proceduresmentioning

confidence: 99%

“…The risk of PPB associated with DBE is 0.5%, but increases with therapeutic intervention[ 8 , 9 ]. The study by Wang et al [ 9 ] recorded seven episodes of PPB in 1531 DBEs (0.5%), with all associated with therapeutic polypectomy . There were no reported incidences of PPB in the studies for diagnostic-only DBE.…”

Section: Diagnostic Endoscopic Proceduresmentioning

confidence: 99%

Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence

Chan

Philpott

Lim

et al. 2020

WJGE

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The role of endoscopic procedures, in both diagnostic and therapeutic purposes is continually expanding and evolving rapidly. In this context, endoscopists will encounter patients prescribed on anticoagulant and antiplatelet medications frequently. This poses an increased risk of intraprocedural and delayed gastrointestinal bleeding. Thus, there is now greater importance on optimal pre, peri and post-operative management of anticoagulant and/or antiplatelet therapy to minimise the risk of post-procedural bleeding, without increasing the risk of a thromboembolic event as a consequence of therapy interruption. Currently, there are position statements and guidelines from the major gastroenterology societies. These are available to assist endoscopists with an evidenced-based systematic approach to anticoagulant and/or antiplatelet management in endoscopic procedures, to ensure optimal patient safety. However, since the publication of these guidelines, there is emerging evidence not previously considered in the recommendations that may warrant changes to our current clinical practices. Most notably and divergent from current position statements, is a growing concern regarding the use of heparin bridging therapy during warfarin cessation and its associated risk of increased bleeding, suggestive that this practice should be avoided. In addition, there is emerging evidence that anticoagulant and/or antiplatelet therapy may be safe to be continued in cold snare polypectomy for small polyps (< 10 mm).

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“… 6 – 13 Few reports in China have focused on SBD detection by DBE in patients of different ages. 14 , 15 …”

Section: Introductionmentioning

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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Outcomes and safety of double-balloon enteroscopy in small bowel diseases: a single-center experience of 1531 procedures

Cited by 21 publications

References 18 publications

Comparison of the Positive Rate and Diagnostic Value of Capsule Endoscopy and Double-Balloon Enteroscopy in Small Bowel Disease: A Retrospective Cohort Analysis

Comparison of the Positive Rate and Diagnostic Value of Capsule Endoscopy and Double-Balloon Enteroscopy in Small Bowel Disease: A Retrospective Cohort Analysis

Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence

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

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