Double-balloon endoscopy in the diagnosis and management of G1 tract diseases： Methodology, indications, safety, and clinical impact

INTRODUCTIONDue to the development of endoscopic instruments and techniques, endoscopy has played an important role in the diagnosis and treatment of disorders in the esophagus, stomach, duodenum, and colon. However, diseases occurring in more hidden area…

Double-balloon endoscopy in the diagnosis and management of GI tract diseases: Methodology, indications, safety, and clinical impact

AIM: To prospectively evaluate the indications, method-ology, safety, and clinical impact of double-balloon en-doscopy.METHODS: A total of 60 patients with suspected or documented small- or large-bowel diseases were investi-gated by double balloon endoscopy. A total of 103 proce-dures were performed (42 from the oral route, 60 from the anal route, and 1 from the stoma route). The main outcome measurements were the time of insertion and the entire examination, complications, diagnostic yields, and the ability to successfully perform treatment.RESULTS: Observation of the entire small intestine was possible in 10 (40%) of 25 patients with total enteros-copy. The median insertion time was 122 min (range, 74-199 min). Observation of the entire colon was possi-ble in 13 (93%) of 14 patients after failure of total colo-noscopy using a conventional colonoscope. Small-intes-tine abnormalities were found in 20 (43%) of 46 patients with indications of suspected or documented small bowel diseases, obscure GI tract bleeding, or a history of ileus. Endoscopic procedures including tattooing (n = 33), bite biopsy (n = 17), radiographic examination (n = 7), EUS (n = 5), hemostasis (n = 1), polypectomy (n = 5), balloon dilatation (n = 1), endoscopic mucosal resection (n = 1) and lithotripsy (n = 1) were all successfully performed. No relevant technical problems or severe complications were encountered.CONCLUSION: Double balloon endoscopy is a feasible technique that allows adequate small and large bowel examination and potentially various endoscopic proce-dures of small-intestinal lesions. It is safe, useful, and also provides a high clinical impact.