Background
Single-balloon enteroscopy (SBE) was introduced in 2007 to diagnose and treat small-bowel
disorders. No study to date has evaluated SBE in patients with surgically altered
anatomy outside of ERCP.
Objective
To evaluate the efficacy, yield, and safety of SBE in patients with surgically altered
anatomy.
Design
Retrospective study.
Setting
Tertiary-care academic medical center.
Patients
All patients with altered surgical anatomy who underwent SBE at the Medical University
of South Carolina from July 2007 to September 2013.
Interventions
SBE.
Main Outcome Measurements
Diagnostic yield, therapeutic yield, technical success, and adverse events.
Results
A total of 48 patients met inclusion criteria. Mean age was 56 years (77% female).
Eleven patients underwent single-balloon PEG placement, 8 single-balloon ERCP, 22
non-PEG/non-ERCP anterograde SBE, and 7 retrograde SBE. Previous surgeries included
Roux-en-Y gastric bypass (n = 26), small-intestine resection (n = 6), colon resection
(n = 5), Whipple procedure (n = 4), choledochojejunostomy (n = 3), hepaticojejunostomy
(n = 1), Billroth I (n = 1), Billroth II (n = 1), and Puestow procedure (n = 1). Procedural
indications were PEG tube placement (n = 11), choledocholithiasis (n = 2), biliary
stricture (n = 2), obstructive jaundice (n = 1), cholangitis (n = 1), ampullary mass
(n = 1), sphincter of Oddi dysfunction (n = 1), anemia and/or bleeding (n = 15), abdominal
pain (n = 9), radiologic evidence of obstruction (n = 3), and Peutz-Jeghers syndrome
(n = 2). The technical success rate was 73% in single-balloon PEG placement, 88% in
single-balloon ERCP, 82% in other anterograde SBEs, and 86% in retrograde SBEs. No
intraprocedural or postprocedural adverse events were observed.
Limitations
Single center, retrospective study.
Conclusion
SBE is safe and effective in patients with surgically altered anatomy.
Abbreviations:
ASA (American Society of Anesthesiologists Physical Status Classification System), ASBE (anterograde single-balloon enteroscopy), DBE (double-balloon enteroscopy), RSBE (retrograde SBE), SBE (single-balloon enteroscopy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 01, 2015
Accepted:
January 4,
2015
Received:
July 14,
2014
Footnotes
DISCLOSURE: J. Romagnuolo is a consultant for and has received honoraria from Olympus and Cook Medical. All other authors disclosed no financial relationships relevant to this article were disclosed.
If you would like to chat with an author of this article, you may contact Dr Brock at [email protected]
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
