Outcome and Safety of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a Tertiary Medical Center in Taiwan

• Published in: PloS one Vol. 11; no. 8; p. e0161188
• Main Authors: Lin, Meng-Chiung, Chen, Peng-Jen, Shih, Yu-Lueng, Huang, Hsin-Hung, Chang, Wei-Kuo, Hsieh, Tsai-Yuan, Huang, Tien-Yu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22.08.2016; Public Library of Science (PLoS)
• Subjects: Abdomen; Adult; Age; Aged; Aged, 80 and over; Angiodysplasia - complications; Angiodysplasia - diagnosis; Angiodysplasia - pathology; Angiodysplasia - surgery; Anterograde transport; Asymptomatic Diseases; Balloon treatment; Biology and Life Sciences; Bleeding; Bowel disease; Care and treatment; Diagnostic systems; Dosage and administration; Endoscopes; Endoscopy; Etiology; Female; Gastroenterology; Gastrointestinal endoscopy; Gastrointestinal hemorrhage; Gastrointestinal Hemorrhage - complications; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - pathology; Gastrointestinal Hemorrhage - surgery; Health care facilities; Hospitals; Humans; Hyperamylasemia - diagnosis; Hyperamylasemia - etiology; Hyperamylasemia - physiopathology; Internal medicine; Intestine; Intestine, Small - blood supply; Intestine, Small - pathology; Intestine, Small - surgery; Intubation; Irritable bowel syndrome; Lesions; Meckel Diverticulum - complications; Meckel Diverticulum - diagnosis; Meckel Diverticulum - pathology; Meckel Diverticulum - surgery; Medical diagnosis; Medicine; Medicine and Health Sciences; Meperidine; Middle Aged; Patient Safety; Patients; Peptic Ulcer - complications; Peptic Ulcer - diagnosis; Peptic Ulcer - pathology; Peptic Ulcer - surgery; Retrograde transport; Retrospective Studies; Risk factors; Safety; Single-Balloon Enteroscopy - instrumentation; Single-Balloon Enteroscopy - methods; Small intestine; Studies; Systematic review; Taiwan; Tertiary Care Centers; Treatment Outcome; Ulcers; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0161188

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.