Double-balloon endoscopy: past, present, and future
Double-balloon endoscopy (DBE) was developed as a new technique for visualization of and intervention in the entire small intestine. In DBE, the intestinal walls are held apart by a balloon attached to the distal end of a soft overtube. DBE has been reported worldwide to be very useful for not only diagnosis but also endoscopic therapy. Biopsy samples of small intestinal tumors can be obtained using DBE, and the appropriate treatment can be selected before a surgical procedure. For inflammatory diseases, DBE can reveal the localization of ulcers in the lumen (on the mesenteric or antimesenteric side), which is important for differential diagnosis. Some endoscopic therapies such as hemostatic procedures, polypectomy, and dilation therapy for benign strictures can be performed in the same manner as in the large intestine. DBE may also be suitable for colonoscopy for difficult insertion cases and therapeutic procedures such as endoscopic submucosal dissection. Furthermore, a double-balloon endoscope can be selectively inserted into the afferent loop to perform endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anastomosis, allowing various kinds of endoscopic treatments for biliary diseases to be successfully performed. Endoscopic therapy in the small intestine, whose wall is very thin, should be performed with special care to avoid complications such as bleeding and perforation. In the future, improvement is expected in terms of maneuverability, therapeutic capability, and imaging technology such as the addition of a magnifying function and flexible spectral imaging color enhancement. We anticipate that DBE will contribute to the establishment of medical science of the small intestine and to research elucidating the mechanisms of small intestinal diseases.
- Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001;53:216–220. CrossRef
- Yamamoto H, Kita H, Sunada K, Hayashi Y, Sato H, Iwamoto M, et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2004;11:1010–1016. CrossRef
- Oi I, Takemoto T, Nakayama K. “Fiberduodenoscopy”-early diagnosis of cancer of the papilla of Vater. Surgery 1970;67:561–565.
- Hiratsuka H. Colonoscopy using the string method for colon guidance. Gastroenterol Endosc 1970;12:209–211 (in Japanese).
- Hiratsuka H, Hasegawa M, Gocho K, Endo T, Suzuki S, Nishikawa F, et al. Endoscopic diagnosis of the small intestine. Stomach and intestine 1972;7:1679–1685 (in Japanese).
- Sugano K, Yamamoto H, Kita H (eds). Double-balloon endoscopy: theory and practice. Tokyo: Springer; 2006.
- Osawa H, Yoshizawa M, Yamamoto H, Kita H, Satoh K, Ohnishi H, et al. Optimal band imaging system can facilitate detection of changes in depressed-type early gastric cancer. Gastrointest Endosc 2008;67:226–234. CrossRef
- Yano T, Yamamoto H, Sunada K, Miyata T, Iwamoto M, Hayashi Y, et al. Endoscopic classification of vascular lesions of the small intestine. Gastrointest Endosc 2008;67:169–172. CrossRef
- Lee YT, Walmsley RS, Leong RW, Sung JJ. Dieulafoy’s lesion. Gastrointest Endosc 2003;58:236–243. CrossRef
- Levine BA, Kaplan BJ. Polyps and polypoid lesions of the jejunum and ileum. Surg Oncol Clin N Am 1996;5:609–619.
- Ohmiya N, Yano T, Yamamoto H, Arakawa D, Nakamura M, Honda W, et al. Diagnosis and treatment of obscure GI bleeding at double balloon endoscopy. Gastrointest Endosc 2007;66:S72–S77. CrossRef
- Omiya N, Taguchi A, Shirai K, Mabuchi N, Arakawa D, Kanazawa H, et al. Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy. Gastrointest Endosc 2005;61:140–147. CrossRef
- Kuno A, Yamamoto H, Kita H, Sunada K, Yano T, Iwamoto M, et al. Application of double-balloon enteroscopy through Roux-en-Y anastomosis for the endoscopic resection of an early carcinoma in the duodenal afferent limb. Gastrointest Endosc 2004;60:1032–1034. CrossRef
- Hayashi Y, Yamamoto H, Kita H, Sunada K, Miyata T, Yano Y, et al. Metallic stent for an obstructing jejunal cancer. J Gastroenterol Hepatol 2006;21:1861. CrossRef
- Sunada K, Yamamoto H, Hayashi Y, Sugano K. Clinical importance of the location of lesions with regard to mesenteric or antimesenteric side of the small intestine. Gastrointest Endosc 2007;66(3 Suppl):S34–S38. CrossRef
- Sunada K, Yamamoto H, Kita H, Yano T, Sato H, Hayashi Y, et al. Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small-intestine. World J Gastroenterol 2005;11:1087–1089.
- Sunada K, Yamamoto H, Kita H, Yano T, Miyata T, Sekina Y, et al. Case report: successful treatment with balloon dilatation in combination with double-balloon enteroscopy of a stricture in the small bowel of a patient with Crohn’s disease. Dig Endosc 2004;16:237–240. CrossRef
- Tanaka S, Mitsui K, Shirakawa K, Tatsuguchi A, Nakamura T, Hayashi Y, et al. Successful retrieval of video capsule endoscopy retained at ileal stenosis of Crohn’s disease using double-balloon endoscopy. J Gastroenterol Hepatol 2006;21:922–923. CrossRef
- Sun B, Shen R, Cheng S, Zhang C, Zhong J. The role of double-balloon enteroscopy in diagnosis and management of incomplete small-bowel obstruction. Endoscopy 2007;39:51–55. CrossRef
- Gay G, Delvaux M. Double-balloon colonoscopy after failed conventional colonoscopy: a pilot series with a new instrument. Endoscopy 2007;39:788–792. CrossRef
- Das A. Future perspective of double balloon endoscopy: newer indications. Gastrointest Endosc 2007;66(3 Suppl):S51–S53. CrossRef
- Yamamoto H, Yube T, Isoda N, Sato Y, Sekine Y, Higashizawa T, et al. A novel method of endoscopic mucosal resection using sodium hyaluronate. Gastrointest Endosc 1999;50:251–256. CrossRef
- Yamamoto H, Kawata H, Sunada K, Sasaki A, Nakazawa K, Miyata T, et al. Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood. Endoscopy 2003;35:690–694. CrossRef
- Moreels TG, Roth B, Vardervliet EJ, Parizel PM, Dutré J, Pelckmans PA. The use of the double-balloon enteroscope for endoscopic retrograde cholangiopancreatography and biliary stent placement after Roux-en-Y hepaticojejunostomy. Endoscopy 2007;39:E196–E197. CrossRef
- Inomata M, Endo M, Obara H, Hashimoto Y, Terui T, Oana S, et al. Endoscopic papillary balloon dilation in the management of common bile duct stones in patient with Roux-en-Y reconstruction. Endoscopy 2004;36:669. CrossRef
- Chu YC, Yeh YH, Yang CC, Chen CH, Yueh SK, Mo LR. A new indication for double-balloon enteroscopy: removal of migrated metal stents through a Roux-en-Y anastomosis. Endoscopy 2007;39:E148. CrossRef
- Mensink PB, Haringsma J, Kucharzif T, Cellier C, Rérez-Cuadrado E, Mönkemuller L, et al. Complications of double balloon enteroscopy: a multicenter survey. Endoscopy 2007;39:613–615. CrossRef
- Honda K, Mizutani T, Nakamura K, Higuchi N, Kanayama K, Sumida Y, et al. Acute pancreatitis associated with peroral double-balloon enteroscopy: a case report. World J Gastroenterol 2006;12:1802–1804.
- Groenen MJ, Moreels TG, Orlent H, Haringsma J, Kuipers EJ. Acute pancreatitis after double-balloon enteroscopy: an old pathogenetic theory revised as a result of using a new endoscopic tool. Endoscopy 2006;38:82–85. CrossRef
- Abdel Aziz AM, Lehman GA. Pancreatitis after endoscopic retrograde cholangio-pancreatography. World J Gastroenterol 2007;13:2655–2668.
- Honda T, Itaba S, Mizutani T, Sumida Y, Kanayama K, Higuchi N, et al. An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: an association with the development of pancreatitis. Endoscopy 2006;38:1040–1043. CrossRef
- Double-balloon endoscopy: past, present, and future
Journal of Gastroenterology
Volume 44, Issue 1 , pp 1-12
- Cover Date
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- Springer Japan
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- double-balloon endoscopy (DBE)
- flexible spectral imaging color enhancement (FICE)
- small intestine
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