Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study

Abstract

Background: Double balloon endoscopy (DBE) is a new diagnostic and therapeutic tool for the management of patients with small-bowel disease. Objective: To evaluate the feasibility, clinical usefulness, and safety of DBE in Korean patients with suspected or known small-bowel disease. Design: Retrospective, multicenter study from April 2004 to March 2006. Setting: University hospitals. Patients: Two hundred twenty-five consecutive patients. Interventions: Subjects underwent 311 procedures with DBE via the oral and/or anal routes. Main Outcome Measurements: The indications, diagnostic yield, therapeutic use, and complications. Results: Overall diagnostic yield was 75% (169/225). Diagnostic yields for obscure GI bleeding (OGIB) (n = 137), chronic abdominal pain (n = 32), radiologic/capule endoscopic abnormality (n = 25), polyposis (n = 9), and chronic diarrhea (n = 9) were 73.7% (101/137), 75.0% (24/32), 64% (16/25), 100% (9/9), and 0% (0/9), respectively In patients with OGIB, Ulcerating lesions (n = 54) were more common than vascular lesions (n = 20) or tumors (n = 27). Some lesions detected in DBE were treated effectively with electrocoagulation or argon plasma coagulation, polypectomy, and dilation. Entrapped capsules were removed easily with polypectomy snare in 3 patients with small-bowel stricture. Some patients with strictures had transient abdominal discomfort during and/or after the procedure. With the exception of I mucosal tear, there were no technical problems or serious complications. Limitations: Descriptive, retrospective study. Conclusions: DBE is safe and useful for diagnosis and treatment of a variety of small-bowel diseases. The most common indication of DBE was OGIB. Ulcerating small-bowel lesions are more common than vascular lesions in Korea.