The European experience with double-balloon enteroscopy: indications, methodology, safety, and clinical impact

Di, Simona; May, Andrea; Heine, Dimitri; Fini, Lucia; Landi, Bruno; Petruzziello, Lucio; Cellier, Christophe; Mulder, Chris J.; Costamagna, Guido; Ell, Christian; Gasbarrini, Antonio

doi:10.1016/j.gie.2005.04.029

Cited by 205 publications

(115 citation statements)

References 23 publications

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“…The evidence available to date comes from unblinded case series performed by expert endoscopists in specialist centres. Patients included in those series were heterogeneous both in terms of indications for the procedure and the therapy performed [11,49,79,80,85]. A meta-analysis of 11 of these studies reported that BAE (almost all were DBE) had a similar sensitivity to SBCE in the diagnosis of small-intestinal inflammatory lesions [86].…”

Section: How Does Dae Compare With Other Imaging Modalities In Patienmentioning

confidence: 99%

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Bourreille¹,

Ignjatovic²,

Aabakken³

et al. 2009

Endoscopy

297

185

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Section: How Does Dae Compare With Other Imaging Modalities In Patienmentioning

confidence: 99%

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Bourreille¹,

Ignjatovic²,

Aabakken³

et al. 2009

Endoscopy

297

185

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“…Indications of IOE have diminished over recent years because of the development of DBE [57] . Despite its current introduction into clinical practice [80][81][82] , IOE is reser ved for those cases in which DBE cannot be performed or fails to investigate the entire small intestine, especially to prevent excessive bowel resection. The advantages and disadvantages of IOE and DBE methods are summarized in Table 1.…”

Section: Overall Experience Of Pjs Patientsmentioning

confidence: 99%

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Kopáčová

Tachecí²,

Rejchrt³

et al. 2009

WJG

187

183

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Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients.

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“…Thus SBE is technically easier to perform than DBE. Despite this advantage, the maximal length of insertion achieved with DBE is significantly greater, 254 +/-174 cm beyond the pylorus, 180 +/-150 cm beyond the ileo-cecal valve, [28] than that with SBE (155 cm).…”

Section: Sbe-ercpmentioning

confidence: 87%

The Role of Overtube-assisted Deep Enteroscopy ERCP in Roux-en-Y Gastric Bypass Patients

Ali¹,

Ahmed²,

Iqbal³

2014

J Obes Weight Loss Ther

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Bariatric surgery is the fastest growing medical intervention for obesity performed in theUS and Roux-en-Y Gastric Bypass (RYGB), is considered the "gold standard"comprising more than 60% of these cases. However, patients with surgically alteredanatomy after undergoing RYGB pose serious challenges to the endoscopist whenaccess to the biliary or pancreatic systems is required. Hurdles include reaching themajor papilla after navigating the length of the roux limb (often >100 cm) given thelimitations of standard gastroscopes and even push enteroscopes in achievingsufficient depth of insertion, orientation (upside-down configuration of the papilla), andthe lack of accessories that are actually designed for the long endoscopes required forperforming ERCPs in this patient population.To work around the aforementioned problems-specifically the length of the Rouxlimb-innovative techniques, notably overtube systems have been developed to allowthe enteroscope to reach the ampulla and perform ERCP. Three overtube-systems arepresently available: Double-balloon Enteroscopy (DBE), Single-balloon Enteroscopy(SBE), and Spiral Enteroscopy (SE). This review is designed to describe the role of these 3overtube systems in assisting with ERCP in RYGB patients based on existing literatureand evaluate their success rates in reaching the ampulla, diagnostic & therapeuticyields, and complication rates.Our review shows good success rates when comparing ability to reach ampulla (DBEERCP:83%; SBE-ERCP: 71%; SE-ERCP: 70%), diagnostic (DBE-ERCP: 77%; SBEERCP:55%; SE-ERCP: 41%) and therapeutic yields (DBE-ERCP: 75%; SBE-ERCP:81%; SE-ERCP: 68%) with low complication rates for all three systems.The sheer volume of RYGB procedures being performed and the associated predictedincrease in complications will lead to advanced endoscopists encountering morepatients with surgically altered anatomy and our review provides evidence thatovertube-assisted systems are effective and safe, and should be considered as a firstline modality in RYGB patients requiring ERCP.

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The European experience with double-balloon enteroscopy: indications, methodology, safety, and clinical impact

Cited by 205 publications

References 23 publications

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED–ECCO consensus

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

The Role of Overtube-assisted Deep Enteroscopy ERCP in Roux-en-Y Gastric Bypass Patients

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