[Complications in double-balloon-enteroscopy: results of the German DBE register].
BACKGROUND
The introduction of double-balloon enteroscopy for the investigation of the small bowel in 2001 was a milestone in GI endoscopy because it allows us to carry out therapeutic interventions as well as diagnostic procedures in the small bowel. Because interventional procedures in endoscopy increase the risk of complications, e.g., in colonoscopy and only limited data were reported regarding the risk of DBE, we introduced a double-balloon enteroscopy register (DBE Register) in Germany.


OBJECTIVE
The purpose of this study was to evaluate the complication rate of DBE in a larger group of patients. We contacted all endoscopic units using DBE in Germany in January 2006 and asked for their participation in the register, the examination data and their present complications beginning in January 2003 until 15.07.2006 using a questionnaire.


RESULTS
The participation rate of 85 endoscopic centres using the DBE technique was 75 % (64 centres). They reported 3894 DBE examinations (2685 using the oral route, 1209 using the anal route) with 1086 interventions. 48 complications were reported (1.2 %). Acute pancreatitis occurred in 9 patients with 1 lethal course of disease, all of them receiving a DBE using the oral route. Thus, the pancreatitis rate after oral DBE was 0.34 %. Perforation happened in 8 cases, all of them needed surgery. One patient died during the course of the disease. 6 perforations occurred after polypectomy, so the perforation rate after polypectomy during DBE is 3.4 % in this study. In 6 cases major bleeding was reported, 4 in the context of polypectomy and 2 after biopsy. All patients received endoscopic treatment and recovered from this complication.


CONCLUSIONS
DBE is in this by now largest collection of cases a safe endoscopic procedure with an overall complication rate of approximately 1%. For diagnostic DBE pancreatitis is the most frequent complication and has to be taken in consideration in the written informed consent.
Möschler
O
O
Marienhospital Osnabrück, Klinik für Innere Medizin/Gastroenterologie, Osnabrück. oliver.moeschler@mho.de
May
A D
AD
Müller
M K
MK
Ell
C
C
D002404:Catheterization / Q000706:statistics & numerical data*; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology*; D007417:Intestinal Polyps / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors