Single Versus Double Balloon Enteroscopy for Small Bowel Diagnostics

Lipka, Seth; Rabbanifard, Roshanak; Kumar, Amit; Brady, Patrick

doi:10.1097/mcg.0000000000000274

Cited by 72 publications

(78 citation statements)

References 27 publications

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“…According to the limited published data regarding SBE, the diagnostic yield ranges from 58% to 70% [5,9–11]. A recent meta-analysis by Lipska et al comparing SBE and DBE showed no significant differences in diagnostic yield, therapeutic yield, insertion depth, procedure time, failure rate, and complication rate [5].…”

Section: Discussionmentioning

confidence: 99%

Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan

et al. 2016

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Single-balloon enteroscopy (SBE) is designed for identifying possible small bowel lesions with balloon-assisted enteroscopy that allows deep intubation of the intestine. However, data regarding the outcome and safety of SBE remain limited. We conducted this study to evaluate the outcome and safety of anterograde and retrograde SBE approaches. This retrospective review from a tertiary medical center in Taiwan included endoscopic reports and chart data from 128 patients with 200 anterograde and retrograde procedures from September 2009 to November 2014. In this study, the most common indication for both anterograde and retrograde SBE was obscure gastrointestinal bleeding (64.4% vs. 60.6%). There were no significant differences between anterograde and retrograde approaches in terms of the diagnostic yield (69.3% vs. 52.5%) and intervention rate (23.8% vs. 17.2%). The procedure time was shorter for anterograde SBE than for retrograde SBE (68.1 ± 23.9 vs. 76.8 ± 27.7 min, P = 0.018). In addition, among the subgroup of patients with obscure gastrointestinal bleeding, the most common etiologies for those in different age-groups were angiodysplasia (≥ 65 years), non-specific ulcers (30–64 years), and Meckel’s diverticulum (< 30 years). The major complication rate during the study was 1.5%; the rate of asymptomatic hyperamylasemia was higher for patients who underwent anterograde SBE than for those who underwent retrograde SBE (13.9% vs. 2%, P = 0.005). The outcome and safety of anterograde and retrograde SBE are similar. However, anterograde SBE has a shorter procedural time and a higher rate of asymptomatic hyperamylasemia.

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Section: Discussionmentioning

confidence: 99%

Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan

et al. 2016

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“…85,86 A recent systematic review and metaanalysis suggested similar performance of single-balloon enteroscopy and DBE in terms of diagnostic and therapeutic yield. 87 Initial series 88 reported a low diagnostic yield with spiral enteroscopy (33%), but a more recent prospective study reported a higher yield (57%-62%) and improved outcomes in terms of transfusion requirements, iron supplementation, and additional therapeutic procedures with spiral enteroscopy in patients with small-bowel disorders. 89 A modeled cost-minimization analysis of the management of small-bowel bleeding proposed BAE as the most cost-effective initial test after standard endoscopy if the goal is treatment or definitive diagnosis, as opposed to visualization alone.…”

Section: Role Of Vcementioning

confidence: 97%

The role of endoscopy in the management of suspected small-bowel bleeding

Gurudu¹,

Bruining²,

Acosta³

et al. 2017

Gastrointestinal Endoscopy

129

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“…Fujinon DBE is commercially available since 2003 and Olympus SBE since 2007. Numerous studies have been performed in search of the best method of device-assisted enteroscopy [9–12]. In addition, device-assisted enteroscopy also allows intubation of the Roux-en-Y afferent limb to perform ERCP, although success rates vary [6, 13–17].…”

Section: Introductionmentioning

confidence: 99%

Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery

Koning

Moreels

2016

BMC Gastroenterol

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BackgroundRoux-en-Y reconstructive surgery excludes the biliopancreatic system from conventional endoscopic access. Balloon-assisted enteroscopy allows therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in these patients, avoiding rescue surgery.The objective of the current study is to compare success and complication rate of double-balloon (DBE) and single-balloon enteroscope (SBE) to perform ERCP in Roux-en-Y patients.MethodsSeventy three Roux-en-Y patients with suspected biliary tract pathology underwent balloon-assisted enteroscopy in a tertiary-care center. Retrospective analysis of 95 consecutive therapeutic ERCP procedures was performed to define and compare success and complication rate of DBE and SBE.ResultsMale-female ratio was 28/45 with a mean age of 58 ± 2 years. 30 (32 %) procedures were performed with DBE and 65 (68 %) with SBE. Overall ERCP success rate was 73 % for DBE and 75 % for SBE (P = 0.831). Failure was due to inability to reach or cannulate the intact papilla or bilioenteric anastomosis. Success rate was significantly higher when performed at the bilioenteric anastomosis (80 % success in 56 procedures) or at the intact papilla in short-limb Roux-en-Y (80 % in 15 procedures) as compared to the intact papilla in long-limb (58 % in 24 procedures; P = 0.040). Adverse event rates were 10 % (DBE) and 8 % (SBE) (P = 0.707) and mostly dealt with conservatively.ConclusionsERCP after Roux-en-Y altered small bowel anatomy is feasible and safe using both DBE and SBE. Both techniques are equally competent with high success rates and acceptable adverse events rates. ERCP at the level of the intact papilla in long limb Roux-en-Y is less successful as compared to short-limb or bilioenteric anastomosis.

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Single Versus Double Balloon Enteroscopy for Small Bowel Diagnostics

Abstract: Performance of SBE and DBE appears to be similar in terms of diagnostic/therapeutic yield, insertion depths, procedure time, complete enteroscopy, failure rates, or adverse events.

Cited by 72 publications

References 27 publications

Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan

Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan

The role of endoscopy in the management of suspected small-bowel bleeding

Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery

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