Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success

Background

Double-balloon enteroscopy (DBE) is an important tool in the evaluation and management of small-bowel disease. Limited data are available on the safety, findings, and outcomes of DBE in elderly patients.

Objective

To determine the safety and efficacy of DBE in elderly patients.

Design

Single-center, retrospective analysis of prospectively collected database.

Setting

Open-access, tertiary care referral center.

Patients

A total of 176 patients undergoing DBE (216 procedures) for evaluation of small-bowel disease between August 2007 and August 2008.

Interventions

Argon plasma coagulation of bleeding small-bowel lesions.

Main Outcome Measurements

DBE complication rate, diagnostic/therapeutic success of DBE.

Methods

An age cutoff of 75 years and older was used to designate patients as elderly. Data on complications, indications, findings, and diagnostic and therapeutic success of DBE were compared between age groups.

Results

The mean age of patients was 66 ± 16.4 years (range 20-95 years). DBE was performed in 185 patients, including 60 patients age 75 years and older and 110 patients younger than age 75. An overall complication rate of 0.9% was seen for DBE in this study, with no significant difference between age groups. No major complications were observed in elderly patients. Elderly patients were more likely to have angioectasias (39% vs 23%; P = .01) and were more likely to require endoscopic therapy during DBE (46.8% vs 29.2%; P = .01).

Limitations

Single-center, retrospective study.

Conclusions

DBE is safe in elderly patients. Elderly patients are more likely to have angioectasias and to require endoscopic therapy during DBE.

Abbreviations: CO₂, carbon dioxide, DBE, double-balloon enteroscopy, OGIB, obscure GI bleeding, VCE, video capsule endoscopy