Double-balloon enteroscopy in elderly patients: is it safe and useful?
OBJECTIVE
Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.


METHODS
We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).


RESULTS
In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).


CONCLUSIONS
DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Dae Han
DH
Choi
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Seong Ran
SR
Jeon
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Jin-Oh
JO
Kim
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Hyun Gun
HG
Kim
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Tae Hee
TH
Lee
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Woong Cheul
WC
Lee
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Byung Soo
BS
Kang
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Jun-Hyung
JH
Cho
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Yunho
Y
Jung
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Wan Jung
WJ
Kim
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Bong Min
BM
Ko
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Joo Young
JY
Cho
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Joon Seong
JS
Lee
Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
Moon Sung
MS
Lee
Double-balloon enteroscopy; Efficacy; Elderly; Safety