Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small-bowel vascular malformations

May, Andrea; Manner, Hendrik; Aschmoneit, Insa; C, Ell

doi:10.1055/s-0030-1256340

Cited by 88 publications

(51 citation statements)

References 16 publications

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“…A single balloon enteroscope and a spiral overtube enteroscope have been recently developed. Single-balloon enteroscopy performance and diagnostic yield was comparable to DBE, whereas spiral enteroscopy showed a reduction in the examination time (22)(23)(24)(25)(26).…”

Section: Introductionmentioning

confidence: 87%

Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

Monsanto¹,

Almeida²,

Lérias³

et al. 2012

Rev. esp. enferm. dig.

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Background: in 21st century, endoscopic study of the small intestine has undergone a revolution with capsule endoscopy and balloon-assisted enteroscopy. The difficulties and morbidity associated with intraoperative enteroscopy, the gold-standard in the 20 th century, made this technique to be relegated to a second level. Aims: evaluate the actual role and assess the diagnostic and therapeutic value of intraoperative enteroscopy in patients with obscure gastrointestinal bleeding.Patients and methods: we conducted a retrospective study of 19 patients (11 males; mean age: 66.5 ± 15.3 years) submitted to 21 IOE procedures for obscure GI bleeding. Capsule endoscopy and double balloon enteroscopy had been performed in 10 and 5 patients, respectively.Results: with intraoperative enteroscopy a small bowel bleeding lesion was identified in 79% of patients and a gastrointestinal bleeding lesion in 94%. Small bowel findings included: angiodysplasia (n = 6), ulcers (n = 4), small bowel Dieulafoy's lesion (n = 2), bleeding from anastomotic vessels (n = 1), multiple cavernous hemangiomas (n = 1) and bleeding ectopic jejunal varices (n = 1). Agreement between capsule endoscopy and intraoperative enteroscopy was 70%. Endoscopic and/or surgical treatment was used in 77.8% of the patients with a positive finding on intraoperative enteroscopy, with a rebleeding rate of 21.4% in a mean 21-month follow-up period. Procedure-related mortality and postoperative complications have been 5 and 21%, respectively.Conclusions: intraoperative enteroscopy remains a valuable tool in selected patients with obscure GI bleeding, achieving a high diagnostic yield and allowing an endoscopic and/or surgical treatment in most of them. However, as an invasive procedure with relevant mortality and morbidity, a precise indication for its use is indispensable.

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Section: Introductionmentioning

confidence: 87%

Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

Monsanto¹,

Almeida²,

Lérias³

et al. 2012

Rev. esp. enferm. dig.

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“…In a small comparison study, there was no significant difference in the diagnostic yield with SE (33.4%) and DBE (47.1%) [38]. In a recent, small, prospective cross-over single center study comparing SE and DBE , SE had a reduced examination time (43 min vs. 65 min) but decreased insertion depth compared to DBE (250 cm vs. 310 cm) [39].…”

Section: Spiral Enteroscopymentioning

confidence: 89%

Advances in Small Bowel Imaging

Tennyson

Semrad

2011

Curr Gastroenterol Rep

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The small intestine has been difficult to examine by traditional endoscopic and radiologic techniques. Within the past 10 years, advances have led to an explosion of technologies that facilitate examination of the entire small intestine. Wireless video capsule endoscopy, deep enteroscopy using balloon-assisted or spiral techniques, computer tomography (CT) and magnetic resonance (MR) enterography have facilitated the diagnosis, monitoring, and management of patients with small intestinal diseases. These technologies are complementary, each with its advantages and limitations. Capsule endoscopy provides a detailed view of the mucosal surface and has excellent patient acceptance, but does not allow therapeutics. Deep enteroscopy allows careful inspection of the mucosa and therapeutics, but is time consuming and invasive. Enterography (CT or MR) allows examination of the small bowel wall and surrounding structures. The initial best test for detecting small intestinal disease depends on clinical presentation and an astute differential diagnosis.

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“…In some series on DBE, no complications during or after DBE were reported (19)(20)(21)(22)(23)(24)(25)(26)(27). But reading these articles carefully, one will find in Pata et al (25) 13% oral bleeding, 2% broken tooth and 2% respiratory depression due to aspiration.…”

Section: Figmentioning

confidence: 99%

Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy

Kopáčová

Bureš

Rejchrt

et al. 2016

Acta Med. (Hradec Kralove, Czech Repub.)

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Summary: Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

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Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small-bowel vascular malformations

Abstract: The results confirm that the new spiral enteroscopy technique reduces the examination time, although the insertion depth with DBE is at present superior.

Cited by 88 publications

References 16 publications

Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

Advances in Small Bowel Imaging

Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy

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