Single‐operator double‐balloon endoscopy (DBE) is as effective as dual‐operator DBE

Background and Study Aims: Double‐balloon endoscopy (DBE) is a new device that allows diagnosis and treatment throughout the entire small intestine. Although the originally described method requires two operators, we have recently developed a method to perform DBE by a single operator. We here assessed the clinical usefulness of this one‐person method in comparison to the conventional two‐person DBE. Patients and Methods: One hundred sixty‐two patients (102 men and 60 women, mean age 59 years) underwent 303 DBE procedures. Total observation time, completion rate of total intestinal and colonic observation, lesion‐discovery rate, and complication rate were retrospectively compared between the one‐person method and the conventional two‐person method of DBE. The one‐person method consists of the Grip and Pinch technique and Keep (or Hold) and Slide technique. Results: The total observation times were 95.5 ± 35.1 min and 96.7 ± 47.5 min by one‐person and two‐person antegrade DBE, respectively, and 103 ± 29.8 min and 111 ± 30.1 min by one‐person and two‐person retrograde DBE, respectively. The completion rate for examination of the entire small intestine was 74.2% in one‐person DBE and 76.5% in two‐person DBE, respectively. The lesion‐discovery rate was 69.0% in one‐person DBE and 65.5% in two‐person DBE, respectively. No significant differences between two methods were found in all measures. Also, no difference was observed in complication rate of the two methods. Conclusions: The single‐operator method for DBE was as efficient as the dual‐operator DBE without any higher risk of complications and, therefore, could replace the conventional dual‐operator method in the future.