Prospective Multicenter Trial Comparing Push-and-Pull Enteroscopy With the Single- and Double-Balloon Techniques in Patients With Small-Bowel Disorders

May, Andrea; Färber, Michael; Aschmoneit, Insa; Pohl, Jürgen; Manner, Hendrik; Lotterer, Erich; Möschler, Oliver; Kunz, Johannes; Gossner, Liebwin; Mönkemüller, Klaus; Ell, Christian
March 2010
American Journal of Gastroenterology;Mar2010, Vol. 105 Issue 3, p575
Academic Journal
OBJECTIVES:Double-balloon enteroscopy (DBE) is now an established method for diagnostic and therapeutic small-bowel endoscopy. Single-balloon enteroscopy (SBE) has been introduced to simplify the technique. A prospective randomized study was carried out to compare the two methods.METHODS:The study included 100 patients (50 in each group; 63 men, 37 women; mean age 55 years), with no previous small-bowel or colon surgery. The indications for enteroscopy were (suspected) mid-gastrointestinal bleeding, Crohn's disease, small-bowel masses, chronic diarrhea or abdominal pain or both, and other conditions. Fujinon instruments were used, with either two balloons or one. The end point of the study was complete enteroscopy as the most objective parameter.RESULTS:No severe complications such as perforation, bleeding, or pancreatitis occurred. Instrument preparation time was significantly faster with SBE than with DBE (P<0.0001). Complete enteroscopy was achieved with the DBE technique in 66% of cases (33 patients), either with the oral route alone or with combined oral and anal approaches. With the SBE technique, the complete enteroscopy rate was significantly lower at 22% (P<0.0001; 11 patients, only with oral and anal routes combined). The rate of therapeutic consequences for the patients based on diagnostic yield and negative complete enteroscopy was significantly higher (P=0.025) in the DBE group at 72%, compared with 48% in the SBE group.CONCLUSIONS:The complete enteroscopy rate was three times higher with DBE than with SBE, accompanied by a higher diagnostic yield. DBE must therefore continue to be regarded as the nonsurgical gold standard procedure for deep small-bowel endoscopy.


Related Articles

  • The utility of single-balloon enteroscopy for the diagnosis and management of small bowel disorders according to their clinical manifestations: a retrospective review. Prachayakul, Varayu; Deesomsak, Morakod; Aswakul, Pitulak; Leelakusolvong, Somchai // BMC Gastroenterology;2013, Vol. 13 Issue 1, p1 

    Background: The advent of double-balloon enteroscopy has enabled more accurate diagnosis and treatment of small bowel disorders. Single-balloon enteroscopy permits visualization of the entire small intestine less often than does double-balloon enteroscopy. However, the relative clinical...

  • Capsule enteroscopy and radiology of the small intestine. Fork, Frans-Thomas; Aabakken, Lars // European Radiology;Dec2007, Vol. 17 Issue 12, p3103 

    In a very few years, the video capsule for small bowel enteroscopy has gained widespread clinical acceptance. It is readily ingested, disposable, and allows for a complete, low-invasive endoscopic examination of the entire mucosa of the small bowel. It is a patient-friendly method and a...

  • Fate of retained capsule: a pathognomonic for surgery. Agaba, Emmanuel A.; Shamseddeen, Hazem; Sasthakonar, Venketesh; Sivalingham, Vadamalayan; Shah, Kavin G.; Ravikumar, Thanjavur S.; Nadjari, Howard; Denoto, George // American Surgeon;Nov2007, Vol. 73 Issue 11, p1140 

    Since its introduction in 2001, Wireless Video Capsule enteroscopy is gaining acceptance due to its high diagnostic potential and minimal risk. In some centers, it offers an alternative approach to visualize the small intestine and to evaluate patients with suspected small bowel disease. We...

  • Ileus secondary to wireless capsule enteroscopy. Magdeburg, R.; Riester, T.; Hummel, F.; Löhr, M.; Post, S.; Sturm, J. // International Journal of Colorectal Disease;Nov2006, Vol. 21 Issue 6, p610 

    Wireless capsule enteroscopy, being a novel, painless investigative technique, is reported to be significantly superior to push enteroscopy in its ability to find bleeding abnormalities in the small intestine. Here we report a case of acute jejunal obstruction following wireless capsule...

  • Editorial: Push-and-Pull Enteroscopy: One Balloon or Two? Ross, Andrew // American Journal of Gastroenterology;Mar2010, Vol. 105 Issue 3, p582 

    Abstract: The past decade has seen several advances in small-bowel endoscopic technologies. Although the endoscopic literature is full of large case series, there are few published prospective randomized trials designed to compare any of the currently available techniques and devices for deep...

  • Small Intestinal Imaging. Kopáčová, Marcela; Van Gossum, Andre; Mulder, Chris J. J.; Vavrečka, Antonín; Bureš, Jan // Gastroenterology Research & Practice;2013, p1 

    No abstract available.

  • Clinical Utility of Double-Balloon Enteroscopy for Small Intestinal Bleeding. Takayoshi Suzuki; Masashi Matsushima; Ichiro Okita; Hiroyuki Ito; Seiho Gocho; Hiroyuki Tajima; Kayoko Tokiwa; Hiromichi Teraoka; Kenichi Watanabe; Takayuki Shirai; Tetsuya Mine // Digestive Diseases & Sciences;Aug2007, Vol. 52 Issue 8, p1914 

    Abstract  Until the development of wireless capsule endoscopy (CE) and double-balloon enteroscopy (DBE), it was extremely difficult to examine the entire small intestine. To assess the usefulness of DBE for diagnosing suspected small intestinal bleeding, we retrospectively...

  • Capsule endoscopy and enteroscopy: modern modalities to investigate the small bowel in paediatrics. Sidhu, R.; Sanders, D. S.; McAlindon, M. E.; Thomson, M. // Archives of Disease in Childhood;Feb2008, Vol. 93 Issue 2, p154 

    Historically the small bowel has been considered a technically difficult area to examine because of its length (3-5 metres), location and tortuosity. Capsule endoscopy and enteroscopy have revolutionised the investigation pathway of the small bowel in adults. They are now developing increasingly...

  • Double-balloon Enteroscopy: The results of a new experience in Iran. Roushan, Nader; Froutan, Hossein; Taslimi, Reza; Kalani, Mohammad; Ganji, Azita; Moghaddam, Sodaif Darvish; Farahvash, Mohammad Jafar; Khazaeipour, Zahra // Medical Journal of the Islamic Republic of Iran;2014, Vol. 28, p1 

    Background: Approach to the small intestine has been difficult even with newer methods. Double-balloon enteroscopy (DBE) has been created for diagnostic and therapeutic interventions in diseases of the small intestine. Small intestinal diseases have different etiologies in each country. The DBE...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics