title: Laparoscopic-assisted double-balloon enteroscopy for small-bowel polyp surveillance and treatment in patients with Peutz-Jeghers syndrome.
abstract: BACKGROUND
  Surveillance and treatment of small-bowel polyps in patients with Peutz-Jeghers syndrome (PJS) can be challenging and may require intraoperative enteroscopy. While initial reports that used double-balloon enteroscopy (DBE) for the resection of small-bowel polyps in patients with PJS appear promising, complete enteroscopy when using this technique may require multiple procedures or may not be possible at all.
  
  
  OBJECTIVE
  To develop a single-procedure approach to the surveillance and the treatment of small-bowel polyps in patients with PJS.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Single, North American tertiary-care center.
  
  
  METHODS
  Individuals with PJS and small-bowel polyps identified by other modalities.
  
  
  METHODS
  DBE was combined with laparoscopy as a single-procedure surveillance and therapeutic strategy for small-bowel PJS polyps.
  
  
  METHODS
  Completion of enteroscopy, number of polyps resected, procedure duration, complications.
  
  
  RESULTS
  Three patients with a history of PJS and known small-bowel polyps underwent laparoscopic-assisted DBE (LADBE). Complete enteroscopy was performed, and all polyps larger than 0.5 cm were resected endoscopically. No cases of cancer or dysplasia were noted; procedure times lasted from 1 to 4 hours. Postoperative complications included ileus in 2 patients.
  
  
  CONCLUSIONS
  Small sample size, single-center experience.
  
  
  CONCLUSIONS
  LADBE holds promise as a new technique that can be used as both a surveillance and a therapeutic tool for small-bowel polyps in patients with PJS.
authors.affiliation: Current affiliations: Section of Endoscopy and Therapeutics and Section of General Surgery, The University of Chicago Hospitals, Chicago, Illinois, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Ross
authors.forename: Charles
authors.initials: C
authors.lastname: Dye
authors.forename: Vivek N
authors.initials: VN
authors.lastname: Prachand
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis / Q000601:surgery*