TY - JOUR
T1 - Complications Associated With Double Balloon Enteroscopy at Nine US Centers
AU - Gerson, Lauren B.
AU - Tokar, Jeffrey
AU - Chiorean, Michael
AU - Lo, Simon
AU - Decker, G. Anton
AU - Cave, David
AU - BouHaidar, Doumit
AU - Mishkin, Daniel
AU - Dye, Charles
AU - Haluszka, Oleh
AU - Leighton, Jonathan A.
AU - Zfass, Alvin
AU - Semrad, Carol
N1 - Funding Information:
Conflict of interest The authors disclose the following: Lauren B. Gerson received speaker's honoraria from Given Imaging Inc and grant support, speaker's honoraria, and equipment from Fujinon Inc. Jeffrey Tokar received grant support and speaker's honoraria from Fujinon Inc. Michael Chiorean is a consultant for Discovery Endoease (Spirus); he received speaker's honoraria from Given Imaging Inc. Simon Lo received grant support and speaker's honoraria from Fujinon Inc. G. Anton Decker received research support from Fujinon Inc. Daniel Mishkin is a consultant for US Endoscopy; he received grant support from EZEM and speaker's honoraria from Given Imaging Inc and Salix. Charles Dye received grant support and speaker's honoraria from Fujinon Inc. Oleh Haluszka is a consultant for EZEM; he received grant support and speaker's honoraria from Fujinon Inc. Jonathan A. Leighton is a consultant for Given Imaging Inc; he received grant support from Fujinon Inc, Olympus, and Given Imaging Inc. Carol Semrad received grant support and speaker's honoraria from Fujinon Inc. The remaining authors disclose no conflicts.
PY - 2009/11
Y1 - 2009/11
N2 - Background & Aims: Double balloon enteroscopy (DBE) was introduced into the US in 2004. Potential complications include perforation, pancreatitis, and gastrointestinal bleeding. Prevalence and risk factors for complications have not been described in a US population. Methods: We conducted a retrospective study of DBE complications in 9 US centers. We obtained detailed information for each complication including patient history, maneuvers performed during the DBE, and presence of altered surgical anatomy. Results: We collected data from 2478 DBE examinations performed from 2004 to 2008. The dataset included 1691 (68%) anterograde DBE, 722 (29%) retrograde DBE (including 5 per-stomal DBEs), and 65 (3%) DBE-facilitated endoscopic retrograde cholangiopancreatography ERCP cases. There were a total of 22 (0.9%) major complications including perforation in 11 (0.4%), pancreatitis in 6 (0.2%), and bleeding in 4 (0.2%) patients. One of 6 cases of pancreatitis occurred post retrograde DBE. Perforations occurred in 3/1691 (0.2%) anterograde examinations and 8/719 (1.1%) retrograde DBEs (P = .004). Eight (73%) perforations occurred during diagnostic DBE examinations. Four of 8 retrograde DBE perforations occurred in patients with prior ileoanal or ileocolonic anastomoses. In the subset of 219 examinations performed in patients with surgically altered anatomy, perforations occurred in 7 (3%), including 1/159 (0.6%) anterograde DBE examinations, 6/60 (10%) retrograde DBEs, and 1 of 5 (20%) peristomal DBE examinations (P < .005 compared with patients without surgically altered anatomy). Conclusions: DBE is associated with a higher complication rate compared with standard endoscopic procedures. The perforation rate was significantly elevated in patients with altered surgical anatomy undergoing diagnostic retrograde DBE examinations.
AB - Background & Aims: Double balloon enteroscopy (DBE) was introduced into the US in 2004. Potential complications include perforation, pancreatitis, and gastrointestinal bleeding. Prevalence and risk factors for complications have not been described in a US population. Methods: We conducted a retrospective study of DBE complications in 9 US centers. We obtained detailed information for each complication including patient history, maneuvers performed during the DBE, and presence of altered surgical anatomy. Results: We collected data from 2478 DBE examinations performed from 2004 to 2008. The dataset included 1691 (68%) anterograde DBE, 722 (29%) retrograde DBE (including 5 per-stomal DBEs), and 65 (3%) DBE-facilitated endoscopic retrograde cholangiopancreatography ERCP cases. There were a total of 22 (0.9%) major complications including perforation in 11 (0.4%), pancreatitis in 6 (0.2%), and bleeding in 4 (0.2%) patients. One of 6 cases of pancreatitis occurred post retrograde DBE. Perforations occurred in 3/1691 (0.2%) anterograde examinations and 8/719 (1.1%) retrograde DBEs (P = .004). Eight (73%) perforations occurred during diagnostic DBE examinations. Four of 8 retrograde DBE perforations occurred in patients with prior ileoanal or ileocolonic anastomoses. In the subset of 219 examinations performed in patients with surgically altered anatomy, perforations occurred in 7 (3%), including 1/159 (0.6%) anterograde DBE examinations, 6/60 (10%) retrograde DBEs, and 1 of 5 (20%) peristomal DBE examinations (P < .005 compared with patients without surgically altered anatomy). Conclusions: DBE is associated with a higher complication rate compared with standard endoscopic procedures. The perforation rate was significantly elevated in patients with altered surgical anatomy undergoing diagnostic retrograde DBE examinations.
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U2 - 10.1016/j.cgh.2009.07.005
DO - 10.1016/j.cgh.2009.07.005
M3 - Article
C2 - 19602453
AN - SCOPUS:70349413518
SN - 1542-3565
VL - 7
SP - 1177-1182.e3
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 11
ER -