title: Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan.
abstract: Single-balloon enteroscopy (SBE) is designed for identifying possible small bowel lesions with balloon-assisted enteroscopy that allows deep intubation of the intestine. However, data regarding the outcome and safety of SBE remain limited. We conducted this study to evaluate the outcome and safety of anterograde and retrograde SBE approaches. This retrospective review from a tertiary medical center in Taiwan included endoscopic reports and chart data from 128 patients with 200 anterograde and retrograde procedures from September 2009 to November 2014. In this study, the most common indication for both anterograde and retrograde SBE was obscure gastrointestinal bleeding (64.4% vs. 60.6%). There were no significant differences between anterograde and retrograde approaches in terms of the diagnostic yield (69.3% vs. 52.5%) and intervention rate (23.8% vs. 17.2%). The procedure time was shorter for anterograde SBE than for retrograde SBE (68.1 ± 23.9 vs. 76.8 ± 27.7 min, P = 0.018). In addition, among the subgroup of patients with obscure gastrointestinal bleeding, the most common etiologies for those in different age-groups were angiodysplasia (≥ 65 years), non-specific ulcers (30-64 years), and Meckel's diverticulum (< 30 years). The major complication rate during the study was 1.5%; the rate of asymptomatic hyperamylasemia was higher for patients who underwent anterograde SBE than for those who underwent retrograde SBE (13.9% vs. 2%, P = 0.005). The outcome and safety of anterograde and retrograde SBE are similar. However, anterograde SBE has a shorter procedural time and a higher rate of asymptomatic hyperamylasemia.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Department of Internal Medicine, Taichiung Armed Forces General Hospital, Taichiung, Taiwan.
authors.forename: Meng-Chiung
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Peng-Jen
authors.initials: PJ
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yu-Lueng
authors.initials: YL
authors.lastname: Shih
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wei-Kuo
authors.initials: WK
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tsai-Yuan
authors.initials: TY
authors.lastname: Hsieh
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Taiwan Association for the Study of Small Intestinal Diseases, Taoyuan, Taiwan.
authors.forename: Tien-Yu
authors.initials: TY
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D058070:Asymptomatic Diseases; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D034321:Hyperamylasemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007421:Intestine, Small / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D061214:Patient Safety; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D000071085:Single-Balloon Enteroscopy / Q000295:instrumentation / Q000379:methods*; D013624:Taiwan; D062606:Tertiary Care Centers; D016896:Treatment Outcome