title: Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases.
abstract: OBJECTIVE
  A specialized system for a new method for enteroscopy, the double-balloon method, was developed. The aim of this study was to evaluate the usefulness of this endoscopic system for small-intestinal disorders.
  
  
  METHODS
  The double-balloon endoscopy system was used to perform 178 enteroscopies (89 by the anterograde approach and 89 by the retrograde approach) in 123 patients. The system was assessed on the basis of the rates of success in jejunal and ileal insertion and the entire examination of the small intestine, diagnostic yields, ability to perform treatment, and complications.
  
  
  RESULTS
  Insertion of the endoscope beyond the ligament of Treitz or ileocecal valve was possible in all 178 procedures. It was possible to observe approximately one half to two thirds of the entire small intestine by each approach, and observation of the entire small intestine was possible in 24 (86%) of 28 trials. The source of bleeding was identified in 50 (76%) of 66 patients with GI bleeding, scrutiny of strictures was possible in 23 patients, and a tumor was examined endoscopically in 17 patients. Two complications (1.1%) occurred. Endoscopic therapies in the small intestine including hemostasis (12 cases), polypectomy (1 case), endoscopic mucosal resection (1 case), balloon dilation (6 cases), and stent placement (2 cases) were performed successfully.
  
  
  CONCLUSIONS
  Double-balloon endoscopy permits the exploration of the small intestine with a high success rate of total enteroscopy. The procedure is safe and useful, and it provides high diagnostic yields and therapeutic capabilities.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Tochigi, Japan. yamamoto@jichi.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kita
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sato
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.forename: Michiko
authors.initials: M
authors.lastname: Iwamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sekine
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Miyata
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuno
authors.forename: Hironari
authors.initials: H
authors.lastname: Ajibe
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ido
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003251:Constriction, Pathologic; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome