title: Complications of double balloon enteroscopy: a multicenter survey.
abstract: OBJECTIVE
  Double balloon enteroscopy (DBE) is a new technique for the visualization of the small bowel. Although the technique is widely used, little is known about the complications. A few complications have been reported in the literature, mainly in case reports. The aim of this study was to establish the complication rate of both diagnostic and therapeutic DBE.
  
  
  METHODS
  A total of 10 centers (nine academic centers and one teaching hospital) across four continents participated in the study. Complications were defined according to the literature. A therapeutic DBE was defined as a DBE with use of argon plasma coagulation, a polypectomy snare, injection of fluids (other than ink for marking), removal of foreign body, or balloon dilation.
  
  
  RESULTS
  A total 85 adverse events were reported in 2362 DBE procedures. In all, 40 events fulfilled the definition of a complication, 13 in 1728 diagnostic DBE (0.8 %) and 27 during 634 therapeutic procedures (4.3 %). The complications were rated minor in 21 (0.9 %), moderate in 6 (0.3 %) and severe in 13 procedures (0.6 %). No fatal complications were reported. Seven cases of pancreatitis were reported, six after diagnostic (0.3 %) and one after therapeutic (0.2 %) DBE.
  
  
  CONCLUSIONS
  Diagnostic DBE is safe with a low complication rate. The complication rate of therapeutic DBE is high compared with therapeutic colonoscopy. The reason for this is unclear. The incidence of pancreatitis after DBE is low (0.3 %), but has to be considered in patients with persistent abdominal complaints after a DBE procedure.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands. p.mensink@erasmusmc.nl
authors.forename: P B F
authors.initials: PB
authors.lastname: Mensink
authors.forename: J
authors.initials: J
authors.lastname: Haringsma
authors.forename: T
authors.initials: T
authors.lastname: Kucharzik
authors.forename: C
authors.initials: C
authors.lastname: Cellier
authors.forename: E
authors.initials: E
authors.lastname: Pérez-Cuadrado
authors.forename: K
authors.initials: K
authors.lastname: Mönkemüller
authors.forename: A
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: A J
authors.initials: AJ
authors.lastname: Kaffes
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: H H
authors.initials: HH
authors.lastname: Yen
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002404:Catheterization; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires