title: Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.
abstract: OBJECTIVE
  This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact.
  
  
  METHODS
  This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed.
  
  
  RESULTS
  Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P < 0.01). Oral insertion depth and length of investigated small bowel in the combined approach were significantly higher in the DBE compared to the SBE group (245 ± 65.3 vs. 218 ± 62.6 and 355 ± 101.9 vs. 319 ± 91.2, respectively; P < 0.001, each). By analyzing only recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P < 0.001) and the usage of sedation was significantly less (propofol: P < 0.001; pethidine: P < 0.05). Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P < 0.001). The rate of severe adverse events was close to zero.
  
  
  CONCLUSIONS
  Both enteroscopy techniques are safe diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.
authors.affiliation: Department of Medicine B, University of Muenster, Albert-Schweitzer-Campus 1, Building A1, Muenster, Germany. lenzph@uni-muenster.de
authors.forename: Philipp
authors.initials: P
authors.lastname: Lenz
authors.forename: Moritz
authors.initials: M
authors.lastname: Roggel
authors.forename: Dirk
authors.initials: D
authors.lastname: Domagk
mesh_terms: D058582:Double-Balloon Enteroscopy / Q000009:adverse effects / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged