Success of single-balloon enteroscopy in patients with surgically altered anatomy

Kurzynske, Frank C.; Romagnuolo, Joseph; Brock, Andrew

doi:10.1016/j.gie.2015.01.017

Cited by 22 publications

(10 citation statements)

References 23 publications

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“…Emmett et al [16] presented 14 patients with prior Roux-en-Y with an 88% successful cannulation rate using DBE. The less time consuming and technically easier SBE-assisted ERCP has a reported success rate between 88% and 92% [17,18]. Finally, with the development of the rotating overtube series evaluating SE-assisted ERCP in surgically altered anatomy were published with a reported success rate between 61% and 80% [19].…”

Section: Methodsmentioning

confidence: 99%

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Fairchild

Hohenwalter

Gipson

et al. 2019

Journal of the American College of Radiology

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Section: Methodsmentioning

confidence: 99%

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Fairchild

Hohenwalter

Gipson

et al. 2019

Journal of the American College of Radiology

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“…This technique also provides permanent access to the upper gastrointestinal tract allowing repeated ERCP procedures in patients with Roux‐en‐Y gastric bypass. Patients with other intestinal surgical reconstructions also benefit from DAE to diagnose and/or treat lesions in gastrointestinal segments out of reach of conventional endoscopes . In particular, enteral metal stent insertion is now possible with the overtube‐assisted technique also in patients with altered anatomy .…”

Section: New Indications For Daementioning

confidence: 99%

“…Patients with other intestinal surgical reconstructions also benefit from DAE to diagnose and/or treat lesions in gastrointestinal segments out of reach of conventional endoscopes. [40][41][42] In particular, enteral metal stent insertion is now possible with the overtube-assisted technique also in patients with altered anatomy. 43,44 After reaching the malignant intestinal obstruction with the help of DAE, the overtube and a guidewire are left in place while the enteroscope is removed and the metal stent is inserted over the guidewire through the overtube under fluoroscopic control.…”

Section: Dae In Patients With Altered Anatomymentioning

confidence: 99%

Update in enteroscopy: New devices and new indications

Moreels

2017

Digestive Endoscopy

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The present review provides an update of the currently available (proto-) types of device-assisted enteroscopy (DAE). In recent years, newly designed double- and single-balloon enteroscopes have emerged. They aim to improve insertion depth into the small bowel, and they also allow more efficient endoscopic interventions. Nowadays, almost all conventional endoscopic procedures are feasible using DAE, opening the door to new indications. Recently, more data have become available on pediatric DAE, DAE-assisted colonoscopy, and DAE in patients with altered anatomy, including DAE-assisted endoscopic retrograde cholangiopancreatography and direct cholangioscopy. Although new enteroscopes are being developed, few comparative studies are available in order to define which DAE suits best for each indication. It is the duty of the international endoscopy community to set up clinical research projects to provide answers to these open questions.

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“…The use of device‐assisted techniques with balloon distension has provided major breakthroughs in endoscopy, allowing more efficient biopsy collection throughout the small and large intestine (Kurzynske et al . ; Chung et al . ).…”

Section: Introductionmentioning

confidence: 99%

“…Balloon-assisted enteroscopy (BAE) is an emerging standard procedure to evaluate and diagnose intestinal diseases by utilizing distensible balloons to hold or pleat intestines to facilitate deep endoscopy (Law, 2016;Moreels, 2017). The use of device-assisted techniques with balloon distension has provided major breakthroughs in endoscopy, allowing more efficient biopsy collection throughout the small and large intestine (Kurzynske et al 2015;Chung et al 2016). The intestinal tract is the main reservoir of bacteria in the human body, and in which microbes are confined in the gut lumen by mucosal barriers Yu, 2015).…”

Section: Introductionmentioning

confidence: 99%

Hypoxia‐induced intestinal barrier changes in balloon‐assisted enteroscopy

Lee

Huang

et al. 2018

The Journal of Physiology

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Balloon-assisted enteroscopy (BAE) is an emerging standard procedure that uses distensible balloons to facilitate deep endoscopy. Intestines are known to harbour an abundant microflora. Whether balloon distension causes perturbation of blood flow and gut barrier dysfunction, and elicits risk of bacterial translocation remains unknown. Our aims were to (1) conduct a prospective study to gather microbiological and molecular evidence of bacterial translocation by BAE in patients, (2) establish a murine model of colonic balloon distension to investigate tissue hypoxia and intestinal barrier, and (3) assess the effect of short- and long-term hypoxia on epithelial permeability using cell lines. Thirteen patients were enrolled for BAE procedures, and blood samples were obtained before and after BAE for paired comparison. Four of the 13 patients (30.8%) had positive bacterial DNA in blood after BAE. Post-BAE endotoxaemia was higher than the pre-BAE level. Nevertheless, no clinical symptom of sepsis or fever was reported. To mimic clinical BAE, mice were subjected to colonic balloon distension. Local tissue hypoxia was observed during balloon inflation, and reoxygenation after deflation. A trend of increased gut permeability was seen after long-term distension, whereas a significant reduction of permeability was observed by short-term distension in the proximal colon. Human colonic epithelial Caco-2 cells exposed to hypoxia for 5-20 min exhibited increased tight junctional assembly, while those exposed to longer hypoxia displayed barrier disruption. In conclusion, sporadic cases of bacteraemia were found after BAE, without septic symptoms. Short-term hypoxia by balloon distension yielded a protective effect whereas long-term hypoxia caused damage to the gut barrier.

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Success of single-balloon enteroscopy in patients with surgically altered anatomy

Cited by 22 publications

References 23 publications

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Update in enteroscopy: New devices and new indications

Hypoxia‐induced intestinal barrier changes in balloon‐assisted enteroscopy

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