Format

Send to

Choose Destination
See comment in PubMed Commons below
Gastrointest Endosc. 2008 May;67(6):890-7. doi: 10.1016/j.gie.2007.07.047. Epub 2008 Feb 21.

Initial experience with double-balloon enteroscopy at a U.S. center.

Author information

1
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida 32224, USA.

Abstract

BACKGROUND:

Double-balloon enteroscopy (DBE) allows direct visualization and intervention in the entire small intestine. Concerns include long procedure times and a long learning curve after training.

OBJECTIVES:

To analyze the initial experience of a single endoscopist when using DBE; assess resource utilization, safety, clinical utility, and the learning curve.

DESIGN:

Prospective study.

SETTING:

Tertiary-referral center.

PATIENTS:

A total of 137 consecutive patients with bleeding or other small-intestine disorders.

MAIN OUTCOME MEASURES:

Clinical impact at the time of DBE and changes in the procedure time and extent with experience.

RESULTS:

Two hundred DBE procedures were performed without major complications. For 115 oral DBEs, the mean (SD) procedure duration was 101 +/- 35 minutes and length of examined small intestine was 220 +/- 80 cm, with no significant change with experience. For 85 anal DBEs, the mean (SD) procedure duration was 96 +/- 33 minutes, and the length examined was 124 +/- 60 cm; the length examined increased with experience, but the duration did not decrease. The percentage of patients in which a DBE had a helpful clinical impact rose from 58% in the first 50 DBEs, to 86% in the last 50 of 200 DBEs. The total enteroscopy rose from 8% in the first 50 DBEs, to 63% in the last 50 of 200 DBEs.

LIMITATIONS:

No follow-up data on outcomes.

CONCLUSIONS:

DBEs required significant time and did not always allow for a total enteroscopy. DBEs were safe and helpful in the management of most patients. An experienced endoscopist may perform a safe and useful DBE after limited training, but the development of expertise may require more than 100 to 150 DBE procedures.

Comment in

PMID:
18178204
DOI:
10.1016/j.gie.2007.07.047
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center