Skip to main content

Advertisement

SpringerLink
Log in

Outcomes and safety of double-balloon enteroscopy in small bowel diseases: a single-center experience of 1531 procedures

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Double-balloon enteroscopy (DBE) has become a routine procedure in clinical practice for evaluation of small bowel diseases (SBDs). This study aimed to evaluate the diagnostic and therapeutic value of DBE in patients with suspected SBDs according to the patients’ age and indications for the procedure.

Methods

The data of patients who underwent DBE at the endoscopy center of Changhai hospital between July 2013 and June 2018 were retrospectively reviewed. All features including demographic characteristics, indications, endoscopic findings, interventions and complications were collected.

Results

A total of 1291 consecutive patients who underwent 1531 DBE procedures (1375 diagnostic and 156 therapeutic) were included. The total diagnostic yield of DBE in cases of suspected SBDs was 58.9% (761/1291). The most common SBDs were Crohn’s disease (CD) followed by tumors. The detection rates of CD and tumors by DBE were 18.3% (236/1291) and 12.7% (164/1291), respectively. The most frequent site of CD was the ileum (199/236, 84.3%), while that of tumors was the proximal small bowel (duodenum and jejunum, 115/164, 70.1%). In the young group (< 45 years), the majority of patients had CD, whereas tumors were the most common disease in the older group (≥ 45 years). The diagnostic yields for occult gastrointestinal bleeding (OGIB) and abdominal pain were 57.3% and 52.4%, respectively. In patients with OGIB, the detection rate of tumor was higher, whereas that of CD was higher in patients with abdominal pain. Polypectomy and foreign body removal were the predominant endoscopic interventions. DBE-associated complications were reported for 14 procedures (0.9%), including 3 diagnostic procedures (0.2%) and 11 therapeutic procedures (7.1%).

Conclusion

DBE is a useful diagnostic tool for the investigation of SBDs, especially for CD and small bowel tumors. DBE is also a safe therapeutic procedure for polypectomy and foreign body removal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, Ido K, Sugano K (2001) Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 53:216–220

    Article  CAS  Google Scholar 

  2. Yamamoto H, Yano T, Kita H, Sunada K, Ido K, Sugano K (2003) New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders. Gastroenterology 125:1556

    Article  Google Scholar 

  3. Pinho R, Mascarenhas-Saraiva M, Mão-de-Ferro S, Ferreira S, Almeida N, Figueiredo P, Rodrigues A, Cardoso H, Marques M, Rosa B, Cotter J, Vilas-Boas G, Cardoso C, Salgado M, Marcos-Pinto R (2016) Multicenter survey on the use of device-assisted enteroscopy in Portugal. United Eur Gastroenterol J 4:264–274

    Article  CAS  Google Scholar 

  4. Hong SN, Kim ER, Ye BD, Jang HJ, Jeon SR, Park SJ, Im JP, Kim JH, Choi CH, Choi H, Chang DK, Small Intestine Research Group of the Korean Association for the Study of Intestinal Diseases (KASID) (2016) Indications, diagnostic yield, and complication rate of balloon-assisted enteroscopy during the first decade of its use in Korea. Dig Endosc 28:443–449

    Article  Google Scholar 

  5. Dişibeyaz S, Suna N, Kuzu UB, Saygılı F, Öztaş E, Ödemiş B, Önal İK, Kılıç ZM, Akdoğan M, Kayaçetin E (2016) Double balloon enteroscopy: a 7-year experience at a tertiary care centre. Eur J Intern Med 33:108–111

    Article  Google Scholar 

  6. Chen WG, Shan GD, Zhang H, Yang M, Yue M, Chen GW, Gu Q, Zhu HT, Xu GQ, Chen LH (2016) Double-balloon enteroscopy in small bowel diseases: eight years single-center experience in China. Medicine 95:42

    Article  Google Scholar 

  7. Tang L, Huang LY, Cui J, Wu CR (2018) Effect of double-balloon enteroscopy on diagnosis and treatment of small-bowel diseases. Chin Med J 131:1321–1326

    Article  Google Scholar 

  8. May A, Nachbar L, Ell C (2005) Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease. Gastrointest Endosc 62:62–70

    Article  Google Scholar 

  9. Choi H, Choi KY, Eun CS, Jang HJ, Park DI, Chang DK, Kim JO, Ko BM, Lee MS, Huh KC, Han DS, Byeon JS, Yang SK, Kim JH, Korean Association for the Study of Intestinal Diseases (2007) Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study. Gastrointest Endosc 66(22):25

    Google Scholar 

  10. Tanaka S, Mitsui K, Yamada Y, Ehara A, Kobayashi T, Seo T, Tatsuguchi A, Fujimori S, Gudis K, Sakamoto C (2008) Diagnostic yield of double-balloon endoscopy in patients with obscure GI bleeding. Gastrointest Endosc 68:683–691

    Article  Google Scholar 

  11. Zhong J, Ma T, Zhang C, Sun B, Chen S, Cao Y, Wu Y (2007) A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel diseases. Endoscopy 39:208–215

    Article  CAS  Google Scholar 

  12. Westerhof J, Weersma RK, Koornstra JJ (2009) Investigating obscure gastrointestinal bleeding: capsule endoscopy or double balloon enteroscopy? Neth J Med 67:260–265

    CAS  PubMed  Google Scholar 

  13. Chen LH, Chen WG, Cao HJ, Zhang H, Shan GD, Li L, Zhang BL, Xu CF, Ding KL, Fang Y, Cheng Y, Wu CJ, Xu GQ (2010) Double-balloon enteroscopy for obscure gastrointestinal bleeding: a single center experience in China. World J Gastroenterol 16:1655–1659

    Article  Google Scholar 

  14. Sunada K, Yamamoto H (2009) Double-balloon endoscopy: past, present, and future. J Gastroenterol 44:1–12

    Article  Google Scholar 

  15. Gomollón F, Dignass A, Annese V, Tilg H, Van Assche G, Lindsay JO, Peyrin-Biroulet L, Cullen GJ, Daperno M, Kucharzik T, Rieder F, Almer S, Armuzzi A, Harbord M, Langhorst J, Sans M, Chowers Y, Fiorino G, Juillerat P, Mantzaris GJ, Rizzello F, Vavricka S, Gionchetti P, ECCO (2017) 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 1: Diagnosis and medical management. J Crohns Colitis 11:3–25

    Article  Google Scholar 

  16. Chen WG, Shan GD, Zhang H, Li L, Yue M, Xiang Z, Cheng Y, Wu CJ, Fang Y, Chen LH (2013) Double-balloon enteroscopy in small bowel tumors: a Chinese single-center study. World J Gastroenterol 19:3665–3671

    Article  Google Scholar 

  17. Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS (2009) Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 249:63–71

    Article  Google Scholar 

  18. Mitsui K, Tanaka S, Yamamoto H, Kobayashi T, Ehara A, Yano T, Goto H, Nakase H, Tanaka S, Matsui T, Iida M, Sugano K, Sakamoto C (2009) Role of double-balloon endoscopy in the diagnosis of small-bowel tumors: the first Japanese multicenter study. Gastrointest Endosc 70:498–504

    Article  Google Scholar 

  19. Achour J, Serraj I, Amrani L, Amrani N (2012) Small bowel tumors: what is the contribution of video capsule endoscopy? Clin Res Hepatol Gastroenterol 36:222–226

    Article  Google Scholar 

  20. Möschler O, May A, Müller MK, Ell C, German DBE Study Group (2011) Complications in and performance of double-balloon enteroscopy (DBE): results from a large prospective DBE database in Germany. Endoscopy 43:484–489

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Peng Wang, Yuxin Wang and Yuanhang Dong contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, 200433, China

    Peng Wang, Yuxin Wang, Yuanhang Dong, Jiefang Guo, Hongyu Fu, Zhaoshen Li & Yiqi Du

Authors
  1. Peng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuxin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuanhang Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiefang Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongyu Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhaoshen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yiqi Du
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design (ZL, YD); acquisition, analysis and interpretation of data (PW, YW, YD, JG, HF); drafting of the manuscript (PW, YW); critical revision of the manuscript for important intellectual content (PW, YD); study supervision (ZL, YD). The article has been approved by all authors to be published.

Corresponding author

Correspondence to Yiqi Du.

Ethics declarations

Disclosures

Drs. Peng Wang, Yuxin Wang, Yuanhang Dong, Jiefang Guo, Hongyu Fu, Zhaoshen Li and Yiqi Du stated that they do not have any conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, P., Wang, Y., Dong, Y. et al. Outcomes and safety of double-balloon enteroscopy in small bowel diseases: a single-center experience of 1531 procedures. Surg Endosc 35, 576–583 (2021). https://doi.org/10.1007/s00464-020-07418-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-07418-6

Keywords

Search

Navigation