title: Double balloon endoscopy associated pancreatitis: a description of six cases.
abstract: OBJECTIVE
  To perform a single-center analysis of all double balloon endoscopy (DBE) related cases of pancreatitis identified prospectively from a recorded DBE-complication database.
  
  
  METHODS
  From November 2003 until January 2007, 603 DBE procedures were performed on 412 patients, with data on complications recorded in a database. The setting was a tertiary care center offering DBE. DBE was performed from the antegrade or retrograde route. Outcome measurements included age, gender, medication, indication, DBE-endoscope type, insertion depth, procedure duration, findings, interventions, post-procedural abdominal pain, and post-procedural hospitalization.
  
  
  RESULTS
  This is the largest single-center study reporting on post-DBE pancreatitis prospectively. Six patients (1.0%) developed post-DBE pancreatitis, all after antegrade DBE. There was no association with gender, duration of the procedure or type of endoscope. The mean age was 51.9 years (range 25-78). Four patients had severe pancreatitis. Of these, two had inflammatory signs in the body-tail region, one had pancreatitis in the tail region, and the total pancreas was involved in one.
  
  
  CONCLUSIONS
  The incidence of post-DBE pancreatitis in our series is higher than previously reported. We found no relation with DBE-endoscope type. The inflammatory changes occurred in the body-tail region of the pancreas, suggesting that post-DBE pancreatitis is caused by repetitive mechanical strain on the pancreas.
authors.affiliation: Small Bowel Unit, Department of Gastroenterology, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. v.jarbandhan@vumc.nl
authors.forename: Soeresh V A
authors.initials: SV
authors.lastname: Jarbandhan
authors.forename: Stijn J B
authors.initials: SJ
authors.lastname: van Weyenberg
authors.forename: Willem M
authors.initials: WM
authors.lastname: van der Veer
authors.forename: Dimitri G N
authors.initials: DG
authors.lastname: Heine
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: Maarten A J M
authors.initials: MA
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D019723:Endoscopes; D016145:Endoscopy, Digestive System / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D011859:Radiography