Original article Clinical endoscopy| Volume 77, ISSUE 1, P62-70, January 2013

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Diagnostic and therapeutic yield is not influenced by the timing of small-bowel enteroscopy: morning versus afternoon


      Small-bowel enteroscopies (BEs) are tedious and prolonged, and their efficacy may be affected by the timing of procedures.


      We aimed to evaluate the differences in diagnostic yield, insertion depth, procedure duration, therapeutic yield, and adverse events (AEs) of enteroscopies performed in the morning versus the afternoon.


      Retrospective cohort study.


      Tertiary referral center.


      Patients who underwent BE for suspected small-bowel disease at a single institution between January 2008 and August 2009.

      Main Outcome Measurement

      Differences in diagnostic yield, insertion depth, procedure duration, therapeutic yield, and AEs between morning (started before noon) and afternoon (after noon) procedures.


      A total of 250 enteroscopies were performed on 250 patients, of which 125 patients (50%) underwent a procedure in the morning and 125 patients (50%) underwent the procedure in the afternoon. The diagnostic yield with anterograde enteroscopy was the same in both the morning and afternoon (63.7% and 63.7%, respectively; P = .99). The procedure durations were also similar (42.4 ± 21.5 minutes vs 46.2 ± 22.4 minutes, respectively; P = .25). Similarly the diagnostic yield with retrograde enteroscopy was similar in morning and afternoon (44.1% and 35.3%, respectively; P = .46). However, the procedure durations of retrograde BE were significantly shorter in the morning compared with the afternoon (51.3 ± 21.3 minutes vs 66.6 ± 32.9 minutes, respectively; P = .03). Therapeutic yield and AEs were similar.


      Retrospective study.


      The timing of procedure, morning versus afternoon, did not affect the diagnostic and therapeutic efficacy of BE in patients with suspected small-bowel disease.


      APC (argon plasma coagulation), AE (adverse event), BE (small-bowel enteroscopy), DBE (double-balloon enteroscopy), SBE (single-balloon enteroscopy), SE (spiral enteroscopy)
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