Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases.
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.
Yamamoto
Hironori
H
Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Tochigi, Japan. yamamoto@jichi.ac.jp
Kita
Hiroto
H
Sunada
Keijiro
K
Hayashi
Yoshikazu
Y
Sato
Hiroyuki
H
Yano
Tomonori
T
Iwamoto
Michiko
M
Sekine
Yutaka
Y
Miyata
Tomohiko
T
Kuno
Akiko
A
Ajibe
Hironari
H
Ido
Kenichi
K
Sugano
Kentaro
K
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