Indications, diagnostic yield, and complication rate of balloon-assisted enteroscopy during the first decade of its use in Korea

Abstract

Background and Aim: Previous studies that addressed the outcome of balloon-assisted enteroscopy (BAE) were based on its early experience. 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. Methods: Thismulticenter study analyzed BAE-related factors of 1108 BAE procedures carried out in 860 patients and compared BAE done at an earlier stage (January 2004-August 2008) to those carried out at a later stage (September 2008-February 2013). Results: 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 the 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 the late stage compared to that during in the early stage (1.8% vs 0.4%, P = 0.020). Conclusion: 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.