title: Learning curve, diagnostic yield and safety of single balloon enteroscopy.
abstract: BACKGROUND
  Single balloon enteroscopy (SBE) is a recently developed diagnostic modality to assess small bowel mucosa. The data on learning curve of SBE is scanty. We aimed to assess the learning curve, diagnostic yield and safety of SBE.
  
  
  METHODS
  All patients who underwent SBE at our centre from December 2007 to December 2010 were included retrospectively. The clinical details, enteroscopy findings and procedure related details were obtained for each patient from a prospectively maintained database. The extent of small bowel visualised with increasing number of procedures by a single endoscopist (Endoscopist A) who performed most of the procedures was used to estimate the learning curve using locally weighted regression curve. The diagnostic yield and complications rates of SBE were also estimated. The study was approved by the institute review board and ethics committee.
  
  
  RESULTS
  Ninety SBEs were performed in 84 patients (age: 42+15 years, 27.4% females). 57 procedures were performed (32 antegrade and 25 retrograde) by endoscopist A. There was gradual improvement in the extent of small bowel visualised during the first 15 procedures via antegrade route followed by flattening of curve. The retrograde route showed no definite trend towards improvement during the procedures performed. The overall diagnostic yield of SBE was 32.1%. There was no complication except for mild self-limiting abdominal pain in one patient.
  
  
  CONCLUSIONS
  SBE via antegrade route has a higher success rate and better learning curve than the retrograde route. SBE is a safe procedure and helps in establishing a diagnosis in one-third of the patients examined.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore - 632 004, Tamil Nadu, India.
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Dutta
authors.forename: Kattiparambil Gangadharan
authors.initials: KG
authors.lastname: Sajith
authors.forename: Anjilivelil J
authors.initials: AJ
authors.lastname: Joseph
authors.forename: Ebby George
authors.initials: EG
authors.lastname: Simon
authors.forename: Ashok
authors.initials: A
authors.lastname: Chacko
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007421:Intestine, Small; D059032:Learning Curve; D008286:Malabsorption Syndromes / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies