title: Double balloon enteroscopy procedure in patients with surgically altered bowel anatomy: analysis of a large prospectively collected database.
abstract: BACKGROUND
  Patients with surgically altered bowel anatomy frequently undergo the double balloon enteroscopy (DBE) procedure to evaluate various small bowel diseases. There are limited data on the diagnostic yield and safety of DBE in these patients. We evaluated the diagnostic yield and complication rates of DBE in patients with surgical altered bowel anatomy. We also evaluated the success rate of DBE in achieving complete examination of the excluded segment of the small bowel and excluded stomach in these patients.
  
  
  METHODS
  Our study was a single-center retrospective analysis of a large prospectively collected DBE database. Patients with a history of surgically altered bowel anatomy who had a DBE procedure performed between January 2006 and August 2011 were included in the study analysis. Patients' demographics, procedure indications, findings, endoscopic interventions, and postprocedural recovery data were recorded. We used frequency statistics to calculate the diagnostic yield and complication rates of DBE in these patients.
  
  
  RESULTS
  In total, 1215 DBEs were performed at our institution during the study period. Sixty-two patients with a history of altered bowel anatomy underwent 53 DBEs and 11 DBE-assisted endoscopic retrograde cholangiopancreatographies (ERCPs). The overall diagnostic yield of DBE was 61%, and that of DBE-assisted ERCP was 64%. No serious early or delayed DBE-associated complications were identified. In patients with surgically altered bowel anatomy containing excluded small bowel and excluded stomach, DBE success rate to achieve their complete examination was 92% (n=46).
  
  
  CONCLUSIONS
  DBE including DBE-assisted ERCP is feasible, safe, and associated with reasonably high diagnostic yield in patients with surgically altered bowel anatomy.
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL 32224, USA. patel.mihir@mayo.edu
authors.forename: Mihir K
authors.initials: MK
authors.lastname: Patel
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Horsley-Silva
authors.forename: Victoria
authors.initials: V
authors.lastname: Gómez
authors.forename: John A
authors.initials: JA
authors.lastname: Stauffer
authors.forename: Mark E
authors.initials: ME
authors.lastname: Stark
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Lukens
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D016208:Databases, Factual; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D007422:Intestines / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies