title: The use of double-balloon enteroscopy in retrieving mucosal biopsies from the entire human gastrointestinal tract.
abstract: OBJECTIVE
  The aim of this explorative study was to evaluate double-balloon enteroscopy (DBE) as a new tool for collecting mucosal biopsies from well-defined parts of the entire small and large bowel in patients with type 2 diabetes and in matched healthy subjects.
  
  
  METHODS
  Twelve subjects with type 2 diabetes and 12 body mass index and age-matched healthy subjects underwent anterograde and retrograde DBE under nurse-administered propofol sedation on two separate days. We attempted to collect two mucosal biopsies from every 30 cm from pylorus to rectum.
  
  
  RESULTS
  A mean of 21 biopsy sites were sampled in the diabetic group versus 25 in the healthy group. In 4 out of 24 patients (2 [17%] from each group) sampling from the entire gastrointestinal system was possible. Mean depth of maximal insertion (anterograde) was 478 ± 32 cm in patients with type 2 diabetes versus 465 ± 44 cm in healthy subjects (p = 0.81) and with retrograde access 230 ± 36 cm (type 2 diabetes) versus 207 ± 26 cm (healthy subjects).
  
  
  CONCLUSIONS
  DBE is a minimally invasive way of collecting fresh biopsies from the entire gastrointestinal tract and, thus provides research and clinical communities with a new possibility to access hitherto unexplored human anatomy and physiology.
authors.affiliation: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark.
authors.forename: Nicolai Alexander
authors.initials: NA
authors.lastname: Rhee
authors.forename: Peter
authors.initials: P
authors.lastname: Vilmann
authors.forename: Hazem
authors.initials: H
authors.lastname: Hassan
authors.forename: Jakob Westergren
authors.initials: JW
authors.lastname: Hendel
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.forename: Tina
authors.initials: T
authors.lastname: Vilsbøll
authors.forename: Filip Krag
authors.initials: FK
authors.lastname: Knop
mesh_terms: D001706:Biopsy / Q000379:methods*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D058582:Double-Balloon Enteroscopy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007413:Intestinal Mucosa / Q000473:pathology*; D007420:Intestine, Large / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol
keywords: biopsy; double-balloon enteroscopy; gastrointestinal tract; methodological study; type 2 diabetes mellitus