The Use of Balloon-assisted Enteroscopy at a Large Volume Centre: A Retrospective Analysis. Issue 1 (27th March 2018)

• Record Type: Journal Article
• Authors: Benmassaoud, Amine; Sasson, Mark Solomon; Pamphile, Jean Caroll; Martel, Myriam; Lakatos, Peter L; Barkun, Alan N; Soulellis, Constantine; Bessissow, Talat
• Is Part Of: Journal of the Canadian Association of Gastroenterology. Volume 1:Issue 1(2018)
• Page Start: 33
• Page End: 39
• Publication Date: 2018-03-27
• Subjects: Diagnostic yield -- Endoscopy -- Small intestine -- Therapeutic yield; Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1093/jcag/gwy007
• Languages: English
• ISSNs: 2515-2084

Abstract

Abstract: Objectives: Balloon-assisted enteroscopy (BAE) is increasingly used for the evaluation of small bowel disorders. We quantified local diagnostic and therapeutic yields of BAE in patients with suspected small bowel diseases. Methods: Adult patients undergoing BAE between January 2010 and July 2015 at McGill University Health Centre were included. Procedures were identified using a prospectively maintained database. Patients were excluded if procedure report was unavailable. Electronic medical records were reviewed. Analyses were restricted to patients who did not have a previous BAE. Results: BAE was performed in 453 patients, including 421 anterograde cases. Patients had a mean age of 61.0 ± 17.5 years. Most common indications for referral were obscure gastrointestinal bleeding (OGIB) (n=207, 45.7%), abnormal imaging (n=88, 19.4%), suspected small bowel neoplasia (SBN) (n=39, 8.6%) and Crohn's disease (CD) (n=31, 6.8%). A diagnosis was established in 216 procedures (47.7%). A pre-endoscopic indication of CD (odds ratio [OR]: 3.78; 95% Confidence Interval [CI], 1.60–8.90), OGIB (OR: 3.69, 95% CI, 2.03–6.71), suspected SBN (OR: 2.45; 95% CI, 1.06–5.65) and previous VCE (OR: 9.33; 95% CI, 3.24–26.90) were associated with abnormal findings. A therapeutic procedure was performed in 126 cases (28.3%). OGIB (OR: 7.00; 95% CI, 3.83–12.81), previous video capsule endoscopy (VCE) (OR: 7.86; 95% CI, 2.93–21.04) and suspected SBN (OR: 6.30; 95% CI, 2.58–21.04) were associated with performance of a therapeutic intervention. Complication rate was 1.6%, with bleeding in seven cases and one perforation. Conclusions: In carefully selected patients, such as those with OGIB, Crohn's disease and previous VCE, BAE was a safe procedure that led to the identification of abnormal findings and therapeutic interventions.