Therapeutic Balloon-Assisted Enteroscopy

Abstract

Since the introduction of the first balloon-based enteroscopic technique in 2001, therapeutic balloon-assisted enteroscopy (BAE) using either the single or double balloon enteroscopy technique (respectively SBE and DBE) has evolved rapidly. Argon plasma coagulation (APC), polypectomy, dilation therapy of strictures, and therapy of the pancreatico-biliary system in patients with surgical altered proximal intestinal anatomy: all have been successfully introduced to treat pathological findings in all segments of the small bowel. The clinical impact of treatment of vascular malformations, strictures caused by chronic inflammation (especially Crohn’s disease) and polypectomy therapy (especially in the Peutz-Jeghers syndrome) seems evident. The decrease of, often repeated, surgical therapy after successful therapeutic BAE in the latter 2 patient groups appears to be a big step forward in treatment. The development of newer enteroscopes, specialized equipment and improved sedation of patients adds positively to the clinical management of undergoing therapeutic BAE. The overall complication rate of therapeutic BAE seems acceptable, but is higher compared to therapeutic colonoscopy which needs further attention in future.

The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures

“…25,[28][29][30][31][32][33] In our experience, SBE demonstrated a yield of 58%, which compares favorably with that of published studies in both SBE and DBE. 5,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Of 172 cases, 72 (42%) were therapeutic, primarily being the treatment of vascular lesions with argon plasma coagulation in 66 cases. The concordance with capsule findings and enteroscopy findings was 40%, with vascular lesions having the highest correlation.…”

“…This retrospective study of our initial experience with SBE demonstrates the abilities of the SBE system to provide a diagnostic yield similar to that of DBE, particularly in patients presenting with obscure GI bleeding. 5,[21][22][23][25][26][27][28][29][30][31][32][33][34][35][36][37] Attributes of SBE proposed by other investigators have included the ease of setup; the intuitive nature of the technique; shorter procedure time, perhaps with or without a corresponding decrease in the depth of insertion; a similar diagnostic yield; and potentially lower costs. 25,[28][29][30][31][32][33] In our experience, SBE demonstrated a yield of 58%, which compares favorably with that of published studies in both SBE and DBE.…”

“…5,[21][22][23][25][26][27][28][29][30][31][32][33][34][35][36][37] Attributes of SBE proposed by other investigators have included the ease of setup; the intuitive nature of the technique; shorter procedure time, perhaps with or without a corresponding decrease in the depth of insertion; a similar diagnostic yield; and potentially lower costs. 25,[28][29][30][31][32][33] In our experience, SBE demonstrated a yield of 58%, which compares favorably with that of published studies in both SBE and DBE. 5,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Of 172 cases, 72 (42%) were therapeutic, primarily being the treatment of vascular lesions with argon plasma coagulation in 66 cases.…”

Diagnostic Approach to Small Bowel Involvement in Inflammatory Bowel Disease: View of the Endoscopist

“…DBE was introduced in 2001 by Yamamoto et al [17] as a new endoscopic modality for visualization of the entire SB, and last year, the SBE technique was introduced by Tsujikawa et al [16] . The term balloon-assisted enteroscopy (BAE) was introduced later on as a unifying terminology referring to both techniques [13,47] . BAE is now considered the standard endoscopic technique for visualization and endoscopic therapy of SB lesions [47] .…”

“…The term balloon-assisted enteroscopy (BAE) was introduced later on as a unifying terminology referring to both techniques [13,47] . BAE is now considered the standard endoscopic technique for visualization and endoscopic therapy of SB lesions [47] .…”