Changes over time in indications, diagnostic yield, and clinical effects of double-balloon enteroscopy

Clin Gastroenterol Hepatol. 2012 Oct;10(10):1152-6. doi: 10.1016/j.cgh.2012.06.024. Epub 2012 Jul 16.

Abstract

Background & aims: We performed a retrospective study to investigate changes between different time periods in the indications, diagnostic yield, and clinical impact of double-balloon enteroscopy (DBE).

Methods: We analyzed records from the database at Soonchunhyang University College of Medicine from all patients undergoing DBE between September 2004 and May 2011 (181 DBEs, 133 patients). We compared DBE-related factors between the first stage (September 2004-August 2006; 117 DBEs, 79 patients) and second stage (September 2006-May 2011; 64 DBEs, 54 patients) of the study period.

Results: The number of DBEs performed decreased between stages. Obscure gastrointestinal bleeding was the most common indication for DBE during each stage (65.8% vs 50%; P = .06). Abnormalities in other modalities as the second indication increased significantly in the second stage compared with the first (11.4% vs 29.6%; P = .008). Between stages, use of computed tomography increased (53.8% vs 81.5%; P = .001), along with capsule endoscopy (29.1% vs 44.4%; P = .06). Mucosal lesions were the most common finding in each stage (56% and 53.1%; P = .686). The diagnostic yield of DBE was 89.3% in the first stage and 93.9% in the second (P = .384). In the first stage, DBE identified 86.4% of cases that had negative results from other modalities; in the second, it identified all cases (P = .3). Therapeutic plans were determined in 89.7% of patients only on the basis of results from DBE.

Conclusions: Between the time periods of 2004-2006 and 2006-2011, the clinical indications for DBEs and outcomes did not change. However, the selectivity of the number of patients decreased between stages.

MeSH terms

  • Adult
  • Double-Balloon Enteroscopy / methods*
  • Double-Balloon Enteroscopy / statistics & numerical data*
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Time Factors