title: Indications, diagnostic yield, and complication rate of balloon-assisted enteroscopy (BAE) during the first decade of its use in Korea.
abstract: Previous studies addressed the outcome of balloon-assisted enteroscopy (BAE) were based on its early experience. This procedure is operator-dependent and requires learning curve. Therefore, the accumulated BAE experience over the last decade might affect its pattern of use and outcome. In order to evaluate the changes of BAE practice over time, we compared the indications, diagnostic yield, and complication rate between the early and late stages of BAE implementation.
  
  
  
  This multicenter study analyzed BAE-related factors of 1,108 BAE procedures performed in 860 patients and compared the BAEs performed in early stage (Jan. 2004-Aug. 2008, n=543 procedures) to those performed in late stage (Sept. 2008-Feb. 2013, n=565 procedures).
  
  
  
  The most common indication for BAE was obscure gastrointestinal bleeding (58.3%). In the early stage, BAE to assess unexplained symptoms/signs was more common (18.8% vs. 9.7%), whereas BAE to confirm abnormal findings of imaging studies was more common in late stage (9.4% vs. 18.8%, P<0.001). Overall diagnostic yield of BAE was 74.6% (95% CI, 72.0%-77.1%). There was no significant difference in the diagnostic yield between the early and late stages (72.2% vs. 77.0%, P=0.073). BAE-associated complications occurred in 12 procedures (1.1%; 95% CI, 0.6%-1.9%). The complication rate decreased significantly in late stage compared to that during early stage (1.8% vs. 0.4%, P=0.020).
  
  
  
  BAE is a safe and useful tool for the diagnosis and management of small bowel disease. With time, the indications for BAE have become more specific and the BAE-associated complication rate has decreased. This article is protected by copyright. All rights reserved.
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sung Noh
authors.initials: SN
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun Ran
authors.initials: ER
authors.lastname: Kim
authors.affiliation: Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.affiliation: Hallym University College of Medicine, Hwaseong, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.affiliation: Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.affiliation: Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Choi
authors.affiliation: The Catholic University of Korea College of Medicine, Incheon, Korea.
authors.forename: Hwang
authors.initials: H
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Chang
keywords: balloon-assisted enteroscopy; complication rate; diagnostic yield; double balloon enteroscopy; indication; single balloon enteroscopy