Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Emanuele Rondonotti; Cristiano Spada; Samuel Adler; Andrea May; Edward J. Despott; Anastasios Koulaouzidis; Simon Panter; Dirk Domagk; Ignacio Fernandez-Urien; Gabriel Rahmi; Maria Elena Riccioni; Jeanin E. van Hooft; Cesare Hassan; Marco Pennazio

doi:10.1055/a-0576-0566

Endoscopy, Table of Contents

Endoscopy 2018; 50(04): 423-446
DOI: 10.1055/a-0576-0566

Technical review

Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Authors

Emanuele Rondonotti

¹Gastroenterology Unit, Ospedale Valduce, Como, Italy
Cristiano Spada

²Digestive Endoscopy Unit, Catholic University of Rome, Rome, Italy

³Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
Samuel Adler

⁴Division of Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel
Andrea May

⁵Department of Medicine II, Sana Klinikum, Offenbach, Germany
Edward J. Despott

⁶Royal Free Unit for Endoscopy, Centre for Gastroenterology, The Royal Free Hospital & University College London, London, UK
Anastasios Koulaouzidis

⁷Endoscopy Unit, The Royal Infirmary of Edinburgh, Scotland, UK
Simon Panter

⁸Department of Gastroenterology, South Tyneside Hospital, South Shields, UK
Dirk Domagk

⁹Department of Medicine B, University of Münster, Münster, Germany
Ignacio Fernandez-Urien

¹⁰Department of Gastroenterology, Hospital de Navarra, Pamplona, Spain
Gabriel Rahmi

¹¹Department of Gastroenterology and Digestive Endoscopy, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
Maria Elena Riccioni

²Digestive Endoscopy Unit, Catholic University of Rome, Rome, Italy
Jeanin E. van Hooft

¹²Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
Cesare Hassan

¹³Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
Marco Pennazio

¹⁴Division of Gastroenterology U, Azienda Ospedaliero-Universitaria, Città della Salute e della Scienza, Turin, Italy

Abstract

Main recommendations

Small-bowel capsule endoscopy (SBCE)

1 ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.

Strong recommendation, high quality evidence.
However, the optimal timing for taking purgatives is yet to be established.

2 ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.

Strong recommendation, moderate quality evidence.

3 ESGE recommends that patients with pacemakers can safely undergo SBCE without special precautions.

Strong recommendation, low quality evidence.

4 ESGE suggests that SBCE can also be safely performed in patients with implantable cardioverter defibrillators and left ventricular assist devices.

Weak recommendation, low quality evidence.

5 ESGE recommends the acceptance of qualified nurses and trained technicians as prereaders of capsule endoscopy studies as their competency in identifying pathology is similar to that of medically qualified readers. The responsibility of establishing a diagnosis must however remain with the attending physician.

Strong recommendation, moderate quality evidence.

6 ESGE recommends observation in cases of asymptomatic capsule retention.

Strong recommendation, moderate quality evidence.

In cases where capsule retrieval is indicated, ESGE recommends the use of device-assisted enteroscopy as the method of choice.

Strong recommendation, moderate quality evidence.

Device-assisted enteroscopy (DAE)

1 ESGE recommends performing diagnostic DAE as a day-case procedure in patients without significant underlying co-morbidities; in patients with co-morbidities and/or those undergoing a therapeutic procedure, an inpatient stay is recommended.

Strong recommendation, low quality evidence

The choice between different settings also depends on sedation protocols.

Strong recommendation, low quality evidence.

2 ESGE suggests that conscious sedation, deep sedation, and general anesthesia are all acceptable alternatives: the choice between them should be governed by procedure complexity, clinical factors, and local organizational protocols.

Weak recommendation, low quality evidence.

3 ESGE recommends that the findings of previous diagnostic investigations should guide the choice of insertion route.
Strong recommendation, moderate quality evidence.

If the location of the small-bowel lesion is unknown or uncertain, ESGE recommends that the antegrade route should be generally preferred.
Strong recommendation, low quality evidence.

In the setting of massive overt bleeding, ESGE recommends an initial antegrade approach.

Strong recommendation, low quality evidence.

4 ESGE recommends that, for balloon-assisted enteroscopy (i. e., single-balloon enteroscopy [SBE] and double-balloon enteroscopy [DBE]), small-bowel insertion depth should be estimated by counting net advancement of the enteroscope during the insertion phase, with confirmation of this estimate during withdrawal.

Strong recommendation, low quality evidence.

ESGE recommends that, for spiral enteroscopy, insertion depth should be estimated during withdrawal.

Strong recommendation, moderate quality evidence.

Since the calculated insertion depth is only a rough estimate, ESGE recommends placing a tattoo to mark the identified lesion and/or the deepest point of insertion.

Strong recommendation, low quality evidence.

5 ESGE recommends that all endoscopic therapeutic procedures can be undertaken at the time of DAE.

Strong recommendation, moderate quality evidence.

Moreover, when therapeutic interventions are performed, additional specific safety measures are needed to prevent complications.

Strong recommendation, high quality evidence.

Full Text

References

References
1 Gerson LB, Fidler JL, Cave DR. et al. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol 2015; 110: 1265-1287
2 Pennazio M, Spada C, Eliakim R. et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2015; 47: 352-376
3 Buscaglia JM, Okolo 3rd PI . Deep enteroscopy: training, indications, and the endoscopic technique. Gastrointest Endosc 2011; 73: 1023-1028
4 ASGE Technology Committee Chauhan SS, Manfredi MA. et al. Enteroscopy. Gastrointest Endosc 2015; 82: 975-990
5 Ladas SD, Triantafyllou K, Spada C. et al. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 2010; 42: 220-227
6 ASGE Technology Committee Wang A, Banerjee S. et al. Wireless capsule endoscopy. Gastrointest Endosc 2013; 78: 805-815
7 Yamamoto H, Ogata H, Matsumoto T. et al. Clinical practice guideline for enteroscopy. Dig Endosc 2017; 29: 519-546
8 Shim KN, Jeon SR, Jang HJ. et al. Quality indicators for small bowel capsule endoscopy. Clin Endosc 2017; 50: 148-160
9 Wang WL, Wu ZH, Sun Q. et al. Meta-analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy. Aliment Pharmacol Ther 2012; 35: 1145-1154
10 ASGE Technology Committee Barth BA, Banerjee S. et al. Equipment for pediatric endoscopy. Gastrointest Endosc 2012; 76: 8-17
11 Mishkin DS, Chuttani R, Croffie J. et al. ASGE Technology Status Evaluation report: wireless capsule endoscopy. Gastrointest Endosc 2006; 63: 539-545
12 Viazis N, Sgouros S, Papaxoinis K. et al. Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study. Gastrointest Endosc 2004; 60: 534-538
13 ASGE Standards of Practice Committee Lee KK, Anderson MA. et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc 2008; 67: 1-9
14 Friedlander JA, Liu QY, Sahn B. et al. NASPGHAN capsule endoscopy clinical report. J Pediatr Gastroenterol Nutr 2017; 64: 485-494
15 Arguelles-Arias F, Donat E, Fernandez-Urien I. et al. Guidelines for wireless capsule endoscopy in children and adolescents: a consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition) and SEOD (Spanish Society for Digestive Disease. Rev Esp Enferm Dig 2015; 107: 714-731
16 Atkins D, Best D, Briss PA. et al. Grading quality of evidence and strength of recommendations. BMJ 2004; 328: 74541490
17 Dumonceau JM, Hassan C, Riphaus A. et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy. Endoscopy 2012; 44: 626-629
18 Mergener K, Ponchon T, Gralnek I. et al. Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/2007. Endoscopy 2007; 39: 895-909
19 Van Tuyl SA, den Ouden H, Stolk MF. et al. Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study. Endoscopy 2007; 39: 1037-1040
20 Wei W, Ge ZZ, Lu H. et al. Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging. Am J Gastroenterol 2008; 103: 77-82
21 Wi JH, Moon JS, Choi MG. et al. Bowel preparation for capsule endoscopy: a prospective randomized multicenter study. Gut Liver 2009; 3: 180-185
22 Pons Beltran V, Gonzalez Suarez B, Gonzalez Asanza C. et al. Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study. Dig Dis Sci 2011; 56: 2900-2905
23 Lapalus MG, Ben Soussan E, Saurin JC. et al. Capsule endoscopy and bowel preparation with oral sodium phosphate: a prospective randomized controlled trial. Gastrointest Endosc 2008; 67: 1091-1096
24 Park SC, Keum B, Seo YS. et al. Effect of bowel preparation with polyethylene glycol on quality of capsule endoscopy. Dig Dis Sci 2011; 56: 1769-1775
25 Oliva S, Cucchiara S, Spada C. et al. Small bowel cleansing for capsule endoscopy in paediatric patients: a prospective randomized single-blind study. Dig Liver Dis 2014; 46: 51-55
26 Niv Y. Efficiency of bowel preparation for capsule endoscopy examination: a meta-analysis. World J Gastroenterol 2008; 14: 1313-1317
27 Rokkas T, Papaxoinis K, Triantafyllou K. et al. Does purgative preparation influence the diagnostic yield of small bowel video capsule endoscopy?: A meta-analysis. Am J Gastroenterol 2009; 104: 219-227
28 Kotwal VS, Attar BM, Gupta S. et al. Should bowel preparation, antifoaming agents, or prokinetics be used before video capsule endoscopy? A systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2014; 26: 137-145
29 Wu S, Gao YJ, Ge ZZ. Optimal use of polyethylene glycol for preparation of small bowel video capsule endoscopy: a network meta-analysis. Curr Med Res Opin 2017; 33: 1149-1154
30 Koulaouzidis A, Giannakou A, Yung DE. et al. Do prokinetics influence the completion rate in small bowel capsule endoscopy? A systematic review and meta-analysis. Curr Med Res Opin 2013; 29: 1171-1185
31 Nouda S, Morita E, Murano M. et al. Usefulness of polyethylene glycol solution with imethylpolysiloxanes for bowel preparation before capsule endoscopy. J Gastroenterol Hepatol 2010; 25: 70-74
32 Fang YH, Chen CX, Zhang BL. Effect of small bowel preparation with simethicone on capsule endoscopy. J Zhejiang Univ Sci B 2009; 10: 46-51
33 Albert J, Gobel CM, Lesske J. et al. Simethicone for small bowel preparation for capsule endoscopy: a systematic, single-blinded, controlled study. Gastrointest Endosc 2004; 59: 487-491
34 Wu L, Cao Y, Liao C. et al. Systematic review and meta-analysis of randomized controlled trials of simethicone for gastrointestinal endoscopic visibility. Scand J Gastroenterol 2011; 46: 227-235
35 Yazici C, Losurdo J, Brown MD. et al. In-patient capsule endoscopy leads to frequent incomplete small bowel examinations. World J Gastroenterol 2012; 18: 5051-5057
36 Robinson CA, Jackson C, Condon D. et al. Impact of in-patient status and gender on small bowel capsule endoscopy findings. Gastrointest Endosc 2011; 74: 1061-1066
37 Shibuya T, Mori H, Takeda T. et al. The relationship between physical activity level and completion rate of small bowel examination in patients undergoing capsule endoscopy. Intern Med 2012; 51: 997-1001
38 Hosono K, Endo H, Sakai E. et al. Optimal approach for small bowel capsule endoscopy using polyethylene glycol and metoclopramide with the assistance of a real-time viewer. Digestion 2011; 84: 119-125
39 Shiotani A, Honda K, Kawakami M. et al. Use of an external real-time image viewer coupled with prespecified actions enhanced the complete examinations for capsule endoscopy. J Gastroenterol Hepatol 2011; 26: 1270-1274
40 Ogata H, Kumai K, Imaeda H. et al. Clinical impact of a newly developed capsule endoscope: usefulness of a real-time image viewer for gastric transit abnormality. J Gastroenterol 2008; 43: 186-192
41 Bandorski D, Kurniawan N, Baltes P. et al. Contraindications for video capsule endoscopy. World J Gastroenterol 2016; 22: 9898-9908
42 Bandorski D, Höltgen R, Stunder D. et al. Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices. Ann Gastroenterol 2014; 27: 3-8
43 Bandorski D, Irnich W, Brück M. et al. Capsule endoscopy and cardiac pacemakers: investigation for possible interference. Endoscopy 2008; 40: 36-39
44 Bandorski D, Irnich W, Brück M. et al. Do endoscopy capsules interfere with implantable cardioverter-defibrillators?. Endoscopy 2009; 41: 457-461
45 Dubner S, Dubner Y, Rubio H. et al. Electromagnetic interference from wireless video-capsule endoscopy on implantable cardioverter-defibrillators. Pacing Clin Electrophysiol 2007; 30: 472-475
46 Bandorski D, Jakobs R, Bruck M. et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: (re)evaluation of the current state in Germany, Austria, and Switzerland 2010. Gastroenterol Res Pract 2012; 2012: 717408
47 Payeras G, Piqueras J, Moreno VJ. et al. Effects of capsule endoscopy on cardiac pacemakers. Endoscopy 2005; 37: 1181-1185
48 Bandorski D, Diehl KL, Jaspersen D. Capsule endoscopy in patients with cardiac pacemakers: current situation in Germany. Z Gastroenterol 2005; 43: 715-718
49 Bandorski D, Lotterer E, Hartmann D. et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter-defibrillators – a retrospective multicenter investigation. J Gastrointestin Liver Dis 2011; 20: 33-37
50 Dirks MH, Costea F, Seidman EG. Successful videocapsule endoscopy in patients with an abdominal cardiac pacemaker. Endoscopy 2008; 40: 73-75
51 Dubner S, Dubner Y, Gallino S. et al. Electromagnetic interference with implantable cardiac pacemakers by video capsule. Gastrointest Endosc 2005; 61: 250-254
52 Guyomar Y, Vandeville L, Heuls S. et al. Interference between pacemaker and video capsule endoscopy. Pacing Clin Electrophysiol 2004; 27: 1329-1330
53 Harris LA, Hansel SL, Rajan E. et al. Capsule endoscopy in patients with implantable electromedical devices is safe. Gastroenterol Res Pract 2013; 2013: 959234
54 Stanich PP, Kleinman B, Betkerur K. et al. Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices. Dig Endosc 2014; 26: 726-730
55 Leighton JA, Srivathsan K, Carey EJ. et al. Safety of wireless capsule endoscopy in patients with implantable cardiac defibrillators. Am J Gastroenterol 2005; 100: 1728-1731
56 Moneghini D, Lipari A, Missale G. et al. Lack of interference between small bowel capsule endoscopy and implantable cardiac defibrillators: an ‘in vivo’ electrophysiological study. United European Gastroenterol J 2016; 4: 216-220
57 Pelargonio G, Dello Russo A, Pace M. et al. Use of video capsule endoscopy in a patient with an implantable cardiac defibrillator. Europace 2006; 8: 1062-1063
58 Cuschieri JR, Osman MN, Wong RC. et al. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review. World J Gastrointest Endosc 2012; 4: 87-93
59 Leighton JA, Sharma VK, Srivathsan K. et al. Safety of capsule endoscopy in patients with pacemakers. Gastrointest Endosc 2004; 59: 567-569
60 Zikos TA, Pan J, Limketkai B. et al. Efficacy of video capsule endoscopy in the management of suspected small bowel bleeding in patients with continuous flow left ventricular assist devices. Gastroenterology Res 2017; 10: 280-287
61 Amornsawadwattana S, Nassif M, Raymer D. et al. Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding. World J Gastroenterol 2016; 22: 4559-4566
62 Elmunzer BJ, Padhya KT, Lewis JJ. et al. Endoscopic findings and clinical outcomes in ventricular assist device recipients with gastrointestinal bleeding. Dig Dis Sci 2011; 56: 3241-3246
63 Meyer MM, Young SD, Sun B. et al. Endoscopic evaluation and management of gastrointestinal bleeding in patients with ventricular assist devices. Gastroenterol Res Pract 2012; 2012: 630483
64 Hanson BJ, Koene RJ, Roy SS. et al. Safety and outcomes of capsule endoscopy in patients with left ventricular assist device: a single-center retrospective case series. J Cardiovasc Transl Res 2016; 9: 402-404
65 Truss WD, Weber F, Pamboukian SV. et al. Early implementation of video capsule enteroscopy in patients with left ventricular assist devices and obscure gastrointestinal bleeding. ASAIO J 2016; 62: 40-45
66 Chung JW, Hwang HJ, Chung MJ. et al. Safety of capsule endoscopy using human body communication in patients with cardiac devices. Dig Dis Sci 2012; 57: 1719-1723
67 Pitocco D, Rizzi A, Tortora A. et al. Possible radio interference between video capsule endoscopy and second-generation omnipod patch pump. Diabetes Technol Ther 2016; 18: 444-445
68 Hogan RB, Ahmad N, Hogan RB. et al. Video capsule endoscopy detection of jejunal carcinoid in life-threatening hemorrhage, first trimester pregnancy. Gastrointest Endosc 2007; 66: 205-207
69 Wax JR, Pinette MG, Cartin A. et al. Cavernous transformation of the portal vein complicating pregnancy. Obstet Gynecol 2006; 108: 782-784
70 Cave D, Legnani P, de Franchis R. et al. ICCE consensus for capsule retention. Endoscopy 2005; 37: 1065-1067
71 Sachdev MS, Leighton JA, Fleischer DE. et al. A prospective study of the utility of abdominal radiographs after capsule endoscopy for the diagnosis of capsule retention. Gastrointest Endosc 2007; 66: 894-900
72 Dokoutsidou H, Karagiannis S, Giannakoulopoulou E. et al. A study comparing an endoscopy nurse and an endoscopy physician in capsule endoscopy interpretation. Eur J Gastroenterol Hepatol 2011; 23: 166-170
73 Niv Y, Niv G. Capsule endoscopy examination – preliminary review by a nurse. Dig Dis Sci 2005; 50: 2121-2124
74 Bossa F, Cocomazzi G, Valvano MR. et al. Detection of abnormal lesions recorded by capsule endoscopy. A prospective study comparing endoscopist’s and nurse’s accuracy. Dig Liver Dis 2006; 38: 599-602
75 Levinthal GN, Burke CA, Santisi JM. The accuracy of an endoscopy nurse in interpreting capsule endoscopy. Am J Gastroenterol 2003; 98: 2669-2671
76 Sidhu R, Sanders DS, Kapur K. et al. Capsule endoscopy: is there a role for nurses as physician extenders?. Gastroenterol Nurs 2007; 30: 45-48
77 Kyriakos N, Karagiannis S, Galanis P. et al. Evaluation of four time-saving methods of reading capsule endoscopy videos. Eur J Gastroenterol Hepatol 2012; 24: 1276-1280
78 Hosoe N, Rey JF, Imaeda H. et al. Evaluations of capsule endoscopy software in reducing the reading time and the rate of false negatives by inexperienced endoscopists. Clin Res Hepatol Gastroenterol 2012; 36: 66-71
79 Günther U, Daum S, Zeitz M. et al. Capsule endoscopy: comparison of two different reading modes. Int J Colorectal Dis 2012; 27: 521-525
80 Nakamura M, Murino A, O’Rourke A. et al. A critical analysis of the effect of view mode and frame rate on reading time and lesion detection during capsule endoscopy. Dig Dis Sci 2015; 60: 1743-1747
81 Zheng Y, Hawkins L, Wolff J. et al. Detection of lesions during capsule endoscopy: physician performance is disappointing. Am J Gastroenterol 2012; 107: 554-560
82 Zagorowicz ES, Pietrzak AM, Wronska E. et al. Small bowel tumors detected and missed during capsule endoscopy: single center experience. World J Gastroenterol 2013; 19: 9043-9048
83 Lewis BS, Eisen GM, Friedman S. A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 2005; 37: 960-965
84 Honda W, Ohmiya N, Hirooka Y. et al. Enteroscopic and radiologic diagnoses, treatment, and prognoses of small bowel tumors. Gastrointest Endosc 2012; 76: 344-354
85 Worsoe J, Fynne L, Gregersen T. et al. Gastric transit and small intestinal transit time and motility assessed by a magnet tracking system. BMC Gastroenterol 2011; 11: 145
86 Koulaouzidis A, Plevris JN. Detection of the ampulla of Vater in small bowel capsule endoscopy: experience with two different systems. J Dig Dis 2012; 13: 621-627
87 Selby WS, Prakoso E. The inability to visualize the ampulla of Vater is an inherent limitation of capsule endoscopy. Eur J Gastroenterol Hepatol 2011; 23: 101-103
88 Clarke JO, Giday SA, Magno P. et al. How good is capsule endoscopy for detection of periampullary lesions? Results of a tertiary-referral center. Gastrointest Endosc 2008; 68: 267-272
89 Saurin JC, Lapalus MG, Cholet F. et al. Can we shorten the small bowel capsule reading time with the “Quick-view” image detection system?. Dig Liver Dis 2012; 44: 477-481
90 Westerhof J, Koornstra JJ, Weersma RK. Can we reduce capsule endoscopy reading times?. Gastrointest Endosc 2009; 69: 497-502
91 Spada C, Hassan C, Costamagna G. Virtual chromoendoscopy: will it play a role in capsule endoscopy?. Dig Liver Dis 2011; 43: 927-928
92 Osawa H, Yamamoto H. Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology. Dig Endosc 2014; 26: 105-115
93 Ryu CB, Song J, Lee MS. et al. Does capsule endoscopy with Alice improves visibility of small bowel lesions?. Gastrointest Endosc 2013; 77: AB466
94 Imagawa H, Oka S, Tanaka S. et al. Improved visibility of lesions of the small intestine via capsule endoscopy with computed virtual chromoendoscopy. Gastrointest Endosc 2011; 73: 299-306
95 Dias de Castro F, Magalhães J, Boal Carvalho P. et al. Improving diagnostic yield in obscure gastrointestinal bleeding – how virtual chromoendoscopy may be the answer. Eur J Gastroenterol Hepatol 2015; 27: 735-740
96 Duque G, Almeida N, Figueiredo P. et al. Virtual chromoendoscopy can be a useful software tool in capsule endoscopy. Rev Esp Enferm Dig 2012; 104: 231-236
97 Koulaouzidis A, Smirnidis A, Douglas S. et al. QuickView in small bowel capsule endoscopy is useful in certain clinical settings, but QuickView with Blue Mode is of no additional benefit. Eur J Gastroenterol Hepatol 2012; 24: 1099-1104
98 Nogales Rincon O, Merino Rodríguez B, González Asanza C. et al. Utility of capsule endoscopy with flexible spectral imaging color enhancement in the diagnosis of small bowel lesions. Gastroenterol Hepatol 2013; 36: 63-68
99 Sato Y, Sagawa T, Hirakawa M. et al. Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions. Endosc Int Open 2014; 2: 80-87
100 Cotter J, Magalhaes J, de Castro FD. et al. Virtual chromoendoscopy in small bowel capsule endoscopy: new light or a cast of shadow?. World J Gastrointest Endosc 2014; 6: 359-365
101 Rimbas M, Negreanu L, Ciobanu L. et al. Is virtual chromoendoscopy useful in the evaluation of subtle ulcerative small bowel lesions detected by video capsule endoscopy?. Endosc Int Open 2015; 3: 615-620
102 Gupta T, Ibrahim M, Deviere J. et al. Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding. World J Gastroenterol 2011; 17: 4590-4595
103 Matsumura T, Arai M, Sato T. et al. Efficacy of computed image modification of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastrointest Endosc 2012; 4: 421-428
104 Koulaouzidis A, Douglas S, Plevris JN. Blue mode does not offer any benefit over white light when calculating Lewis score in small bowel capsule endoscopy. World J Gastrointest Endosc 2012; 4: 33-37
105 Kobayashi Y, Watabe H, Yamada A. et al. Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy. J Dig Dis 2012; 13: 614-620
106 Maeda M, Hiraishi H. Efficacy of video capsule endoscopy with flexible spectral imaging color enhancement at setting 3 for differential diagnosis of red spots in the small bowel. Dig Endosc 2014; 26: 228-231
107 Konishi M, Shibuya T, Mori H. et al. Usefulness of flexible spectral imaging color enhancement for the detection and diagnosis of small intestinal lesions found by capsule endoscopy. Scand J Gastroenterol 2014; 49: 501-505
108 Boal Carvalho P, Magalhães J, Dias de Castro F. et al. Virtual chromoendoscopy improves the diagnostic yield of small bowel capsule endoscopy in obscure gastrointestinal bleeding. Dig Liver Dis 2016; 48: 172-175
109 Abdelaal UM, Morita E, Nouda S. et al. Blue mode imaging may improve the detection and visualization of small bowel lesions: A capsule endoscopy study. Saudi J Gastroenterol 2015; 21: 418-422
110 Yung DE, Boal Carvalho P, Giannakou A. et al. Clinical validity of flexible spectral imaging color enhancement (FICE) in small bowel capsule endoscopy: a systematic review and meta-analysis. Endoscopy 2017; 49: 258-269
111 Krystallis C, Koulaouzidis A, Douglas S. et al. Chromoendoscopy in small bowel capsule endoscopy: Blue mode or Fuji Intelligent Colour Enhancement?. Dig Liver Dis 2011; 43: 953-957
112 Sakai E, Endo H, Kato S. et al. Capsule endoscopy with flexible spectral imaging color enhancement reduces the bile pigment effect and improves the detectability of small bowel lesions. BMC Gastroenterol 2012; 12: 83
113 Ponte A, Pinho R, Rodrigues A. et al. Review of small bowel cleansing scales in capsule endoscopy: a panoply of choices. World J Gastrointest Endosc 2016; 16: 600-609
114 Gralnek IM, de Franchis R, Seidman E. et al. Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change. Aliment Pharmacol Ther 2008; 27: 146-154
115 Niv Y, Ilani S, Levi Z. et al. Validation of the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score): a multicenter prospective study. Endoscopy 2012; 44: 21-26
116 Girelli CM, Porta P, Colombo E. et al. Development of a novel index to discriminate bulge from mass on small bowel capsule endoscopy. Gastrointest Endosc 2011; 74: 1067-1074
117 Shyung LR, Lin SC, Shih SC. et al. Proposed scoring system to determine small bowel mass lesions using capsule endoscopy. J Formos Med Assoc 2009; 108: 533-538
118 Saurin JC, Pioche M. Why should we systematically specify the clinical relevance of images observed at capsule endoscopy?. Endosc Int Open 2014; 2: 88-89
119 Li X, Chen H, Dai J. et al. Predictive role of capsule endoscopy on the insertion route of double-balloon enteroscopy. Endoscopy 2009; 41: 762-766
120 Delvaux M, Fassler I, Gay G. Clinical usefulness of the endoscopic video capsule as the initial intestinal investigation in patients with obscure digestive bleeding: validation of a diagnostic strategy based on the patient outcome after 12 months. Endoscopy 2004; 36: 1067-1073
121 Rezapour M, Amadi C, Gerson L. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc 2017; 85: 1157-1168.e2
122 Liao Z, Gao R, Xu C. et al. Indications and detection, completion and retention rates of small bowel capsule endoscopy: a systematic review. Gastrointest Endosc 2010; 71: 280-286
123 Fernandez-Urien I, Carretero C, González B. et al. Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population. Rev Esp Enferm Dig 2015; 107: 745-752
124 Um S, Poblete H, Zavotsky J. Small bowel perforation caused by an impacted endocapsule. Endoscopy 2008; 40: 122-123
125 Skovsen AP, Burchart J, Burgdorf SK. Capsule endoscopy: a cause of late small bowel obstruction and perforation. Case Rep Surg 2013; 2013: 458108
126 Royall NA, Fiscina CD. Report of video-capsule endoscopy disruption producing episodic small bowel obstruction after prolonged retention. Int J Surg Case Rep 2014; 5: 1001-1004
127 Cheifetz AS, Lewis BS. Capsule endoscopy retention: is it a complication?. J Clin Gastroenterol 2006; 40: 688-691
128 Cheon JH, Kim YS, Lee IS. et al. Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention. Endoscopy 2007; 39: 1046-1052
129 Vanfleteren L, van der Schaar P, Goedhard J. Ileus related to wireless capsule retention in suspected Crohn’s disease: emergency surgery obviated by early pharmacological treatment. Endoscopy 2009; 41: 134-135
130 Li F, Gurudu SR, De Petris G. et al. Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures. Gastrointest Endosc 2008; 68: 174-180
131 Rondonotti E, Herrerias JM, Pennazio M. et al. Complications, limitations and failures of capsule endoscopy: a review of 733 cases. Gastrointest Endosc 2005; 62: 712-716
132 Hoog CM, Bark LA, Arkani J. et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract 2012; 2012: 518718
133 Sears DM, Avots-Avontins A, Culp K. et al. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc 2004; 60: 822-827
134 Harrington C, Rodgers C. The longest duration of retention of a video capsule. BMJ Case Rep 2014;
135 Van Weyenberg SJ, Van Turenhout ST, Bouma G. et al. Double-balloon endoscopy as the primary method for small bowel video capsule endoscope retrieval. Gastrointest Endosc 2010; 71: 535-541
136 Makipour K, Modiri AN, Ehrlich A. et al. Double balloon enteroscopy: effective and minimally invasive method for removal of retained video capsules. Dig Endosc 2014; 26: 646-649
137 Mitsui K, Fujimori S, Tanaka S. et al. Retrieval of retained capsule endoscopy at small bowel stricture by double-balloon endoscopy significantly decreases surgical treatment. J Clin Gastroenterol 2016; 50: 141-146
138 Koulaouzidis A, Rondonotti E, Karargyris A. Small bowel capsule endoscopy: a ten-point contemporary review. World J Gastroenterol 2013; 19: 3726-3746
139 Despott EJ, O'Rourke A, Anikin V. et al. Tracheal aspiration of capsule endoscopes: detection, management, and susceptibility. Dig Dis Sci 2012; 57: 1973-1974
140 Yung DE, Plevris JN, Koulaouzidis A. Short article: Aspiration of capsule endoscopes: a comprehensive review of the existing literature. Eur J Gastroenterol Hepatol 2017; 29: 428-434
141 Holden JP, Dureja P, Pfau PR. et al. Endoscopic placement of the small bowel video capsule by using a capsule endoscope delivery device. Gastrointest Endosc 2007; 65: 842-847
142 Almeida N, Figueiredo P, Lopes S. et al. Capsule endoscopy assisted by traditional upper endoscopy. Rev Esp Enferm Dig 2008; 100: 758-763
143 Carey EJ, Heigh RI, Fleischer DE. Endoscopic capsule endoscope delivery for patients with dysphagia, anatomical abnormalities, or gastroparesis. Gastrointest Endosc 2004; 59: 423-426
144 Rondonotti E, Soncini M, Girelli C. et al. Small bowel capsule endoscopy in clinical practice: a multicentre 7-years survey. Eur J Gastroenterol 2010; 22: 1380-1386
145 Postgate AJ, Burling D, Gupta A. et al. Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: a 3-year technical review. Dig Dis Sci 2008; 53: 2732-2738
146 Al-Bawardy B, Locke G, Huprich JE. et al. Retained capsule endoscopy in a large tertiary care academic practice and radiologic predictors of retention. Inflamm Bowel Dis 2015; 21: 2158-2164
147 Signorelli C, Rondonotti E, Villa F. et al. Use of the Given Patency System for the screening of patients at high risk for capsule retention. Dig Liver Dis 2006; 38: 326-330
148 Du J, Pan D, Ma P. et al. The clinical characteristic and risk of capsule incomplete and retention in Crohn’s disease. Int J Clin Exp Med 2015; 5: 13482-90
149 Spada C, Spera G, Riccioni M. et al. A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule. Endoscopy 2005; 37: 793-800
150 Zhang W, Han ZL, Cheng Y. et al. Value of the patency capsule in pre-evaluation for capsule endoscopy in cases of intestinal obstruction. J Dig Dis 2014; 15: 345-351
151 Yadav A, Heigh RI, Hara AK. et al. Performance of the patency capsule compared with nonenteroclysis radiologic examinations in patients with known or suspected intestinal strictures. Gastrointest Endosc 2011; 74: 834-839
152 Rondonotti E, Soncini M, Girelli CM. et al. Short article: Negative small bowel cross-sectional imaging does not exclude capsule retention in high-risk patients. Eur J Gastroenterol Hepatol 2016; 28: 871-875
153 Kopylov U, Nemeth A, Cebrian A. et al. Symptomatic retention of the patency capsule: a multicenter real life case series. Endosc Int Open 2016; 4: 964-969
154 Chokshi RV, Hovis CE, Hollander T. et al. Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy. Gastrointest Endosc 2012; 75: 1197-1203
155 Phillips SF. Functions of the large bowel: an overview. Scand J Gastroenterol Suppl 1984; 93: 1-12
156 Spiller RC. Intestinal absorptive function. Gut 1994; 35: S5-S9
157 Volk N, Lacy B. Anatomy and physiology of the small bowel. Gastrointest Endosc Clin N Am 2017; 27: 1-13
158 Lin MC, Chen PJ, Shih YL. et al. Outcome and safety of anterograde and retrograde single-balloon enteroscopy: clinical experience at a tertiary medical center in Taiwan. PLoS One 2016; 11: e0161188
159 Lenz P, Roggel M, Domagk D. Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance. Int J Colorectal Dis 2013; 28: 1239-1246
160 May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease. Gastrointest Endosc 2005; 62: 62-70
161 Yamamoto H, Kita H, Sunada K. et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2004; 2: 1010-1016
162 Hassan C, Bretthauer M, Kaminski MF. et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2013; 45: 142-150
163 Johnson DA, Barkun AN, Cohen LB. et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology 2014; 147: 903-924
164 Aniwan S, Viriyautsahakul V, Angsuwatcharakon P. et al. Comparison of urgent video capsule endoscopy and urgent double-balloon endoscopy in massive obscure gastrointestinal bleeding. Hepatogastroenterology 2014; 61: 1990-1994
165 Monkemuller K, Neumann H, Meyer F. et al. A retrospective analysis of emergency double-balloon enteroscopy for small-bowel bleeding. Endoscopy 2009; 41: 715-717
166 Mensink PB, Haringsma J, Kucharzik T. et al. Complications of double balloon enteroscopy: A multicenter survey. Endoscopy 2007; 39: 613-615
167 Gerson LB, Tokar J, Chiorean M. et al. Complications associated with double balloon enteroscopy at nine US centers. Clin. Gastroenterol Hepatol 2009; 7: 1177-1182
168 Möschler O, May A, Muller MK. et al. Complications in and performance of double-balloon enteroscopy (DBE): Results from a large prospective DBE database in Germany. Endoscopy 2011; 43: 484-489
169 Despott EJ, Murino A, Hughes S. et al. Second report of the UK multi-centre DBE registry: furthering the international DBE experience. Gastrointest Endosc 2011; 73: AB394
170 Rondonotti E, Sunada K, Yano T. et al. Double-balloon endoscopy in clinical practice: where are we now?. Dig Endosc 2012; 24: 209-219
171 Moeschler O, Mueller MK. Deep enteroscopy – indications, diagnostic yield and complications. World J Gastroenterol 2015; 21: 1385-1393
172 Cotton PB, Eisen GM, Aabakken L. et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
173 Hirai F, Beppu T, Sou S. et al. Endoscopic balloon dilatation using double-balloon endoscopy is a useful and safe treatment for small intestinal strictures in Crohn’s disease. Dig Endosc 2010; 22: 200-204
174 Xin L, Liao Z, Jiang YP. et al. Indications, detectability, positive findings, total enteroscopy and complications of diagnostic double-balloon endoscopy: a systematic review of data over the first decade of use. Gastrointest Endosc 2011; 74: 563-570
175 Möschler O, May AD, Müller MK. et al. Complications in double-balloon-enteroscopy: results of the German DBE register. DBE-Studiengruppe Deutschland. Z Gastroenterol 2008; 46: 266-270
176 Teshima CW, Aktas H, Kuipers EJ. et al. Hyperamylasemia and pancreatitis following spiral enteroscopy. Can J Gastroenterol 2012; 26: 603-606
177 Zepeda-Gomez S, Barreto-Zuniga R. et al. Risk of hyperamylasemia and acute pancreatitis after double-balloon enteroscopy: a prospective study. Endoscopy 201 43: 766-770
178 Tsujikawa T, Bamba S, Inatomi O. et al. Factors affecting pancreatic hyperamylasemia in patients undergoing peroral single-balloon enteroscopy. Dig Endosc 2015; 27: 674-678
179 Kopacova M, Tacheci I, Rejchrt S. et al. Double balloon enteroscopy and acute pancreatitis. World J Gastroenterol 2010 21 16: 2331-2340
180 Pata C, Akyuz U, Rzin Y. et al. Post-procedure elevated amylase and lipase levels after double-balloon enteroscopy: relations with the double-balloon technique. Dig Dis Sci 2010; 55: 1982-1988
181 Judah JR, Draganov PV, Lam Y. et al. Spiral enteroscopy is safe and effective for an elderly United States population of patients with numerous comorbidities. Clin Gastroenterol Hepatol 2010; 8: 572-576
182 Akerman PA, Cantero D. Spiral enteroscopy and push enteroscopy. Gastrointest Endosc Clin N Am 2009; 19: 357-369
183 Chavalitdhamrong D, Adler DG, Draganov PV. Complications of enteroscopy: how to avoid them and manage them when they arise. Gastrointest Endosc Clin N Am 2015; 25: 83-95
184 Khashab MA, Lennon AM, Dunbar KB. et al. A comparative evaluation of single-balloon enteroscopy and spiral enteroscopy for patients with mid-gut disorders. Gastrointest Endosc 2010; 72: 766-772
185 Davis-Yadley AH, Lipka S, Rodriguez AC. et al. The safety and efficacy of single balloon enteroscopy in the elderly. Therap Adv Gastroenterol 2016; 9: 169-179
186 Manno M, Riccioni ME, Cannizzaro R. et al. Diagnostic and therapeutic yield of single balloon enteroscopy in patients with suspected small-bowel disease: results of the Italian multicentre study. Dig Liver Dis 2013; 45: 211-215
187 Shinozaki S, Yamamoto H, Yano T. et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151-158
188 Byeon J-S, Mann NK, Jamil LH. et al. Double balloon enteroscopy can be safely done in elderly patients with significant co-morbidities. J Gastroenterol Hepatol 2012; 27: 1831-1836
189 Sidhu R, Sanders DS. Double-balloon enteroscopy in the elderly with obscure gastrointestinal bleeding: safety and feasibility. Eur J Gastroenterol Hepatol 2013; 25: 1230-1234
190 Akarsu M, Akkaya Ozdinç S, Celtik A. et al. Diagnostic and therapeutic efficacy of double-balloon endoscopy in patients with small intestinal diseases: single-center experience in 513 procedures. Turk J Gastroenterol 2014; 25: 374-380
191 Lahat A, Nadler M, Simon C. et al. Double balloon enteroscopy: a 2 year experience. Isr Med Assoc J 2009; 11: 456-459
192 Disibeyaz S, Suna N, Kuzu UB. et al. Double balloon enteroscopy: A 7-year experience at a tertiary care Centre. Eur J Intern Med 2016; 33: 108-111
193 Choi DH, Jeon SR, Kim JO. et al. Double-balloon enteroscopy in elderly patients: is it safe and useful?. Intest Res 2014; 12: 313-319
194 Cazzato IA, Cammarota G, Nista EC. et al. Diagnostic and therapeutic impact of double-balloon enteroscopy (DBE) in a series of 100 patients with suspected small bowel diseases. Dig Liver Dis 2007; 39: 483-487
195 Yang DH. Questions about sedation protocols for double-balloon enteroscopy. Intest Res 2015; 13: 97-98
196 Zubek L, Szabo L, Lakatos PL. et al. Double balloon enteroscopy examinations in general anesthesia. World J Gastroenterol 2010; 16: 3418-3422
197 Sethi S, Thaker AM, Cohen J. et al. Monitored anesthesia care without endotracheal intubation is safe and efficacious for single-balloon enteroscopy. Dig Dis Sci 2014; 59: 2184-2190
198 Jensen JT, Hornslet P, Konge L. et al. High efficacy with deep nurse-administered propofol sedation for advanced gastroenterologic endoscopic procedures. Endosc Int Open 2016; 4: E107-E111
199 Kawano S, Okada H, Iwamuro M. et al. An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy. Digestion 2015; 91: 112-116
200 Judah JR, Collins D, Gaidos JK. et al. Prospective evaluation of gastroenterologist-guided, nurse-administered standard sedation for spiral deep small bowel enteroscopy. Dig Dis Sci 2010; 55: 2584-2591
201 American Society of Anesthesiologists. ASA Physical Status Classification System. Available at: https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system Accessed March 2017
202 Murino A, Nakamura M, Despott EJ. et al. Factors associated with reduced insertion depth at double balloon enteroscopy: a retrospective, multivariate analysis. Dig Liver Dis 2014; 46: 956-958
203 Tanaka S, Mitsui K, Tatsuguchi A. et al. Current status of double balloon endoscopy–indications, insertion route, sedation, complications, technical matters. Gastrointest Endosc 2007; 66: S30-S33
204 Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy 2006; 38: 49-58
205 Mandaliya R, Korenblit J, O’Hare B. et al. Spiral enteroscopy utilizing capsule location index for achieving high diagnostic and therapeutic yield. Diagn Ther Endosc 2015; 793516
206 Sanaka M, Navaneethan U, Kosuru B. et al. Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small bowel disease. Clin Gastroenterol Hepatol 2012; 910-916
207 Akyuz U, Pata C, Kalayci M. et al. Route selection for double balloon enteroscopy in patients with obscure gastrointestinal bleeding: experience from a single center. Turk J Gastroenterol 2012; 23: 670-675
208 Kaufman D, Leslie G, Marya N. et al. Small intestinal angioectasia: characterization, risk factors, and rebleeding. J Clin Gastroenterol 2016; 51: 720-727
209 Plotkin E, Imaeda A. Small intestinal angioectasias are not randomly distributed in the small bowel and most may be reached by push enteroscopy. J Clin Gastroenterol 2016; 50: 561-565
210 Bollinger E, Raines D, Saitta P. Distribution of bleeding gastrointestinal angioectasias in Western population. World J Gastroenterol 2012; 18: 6235-6239
211 Jackson C, Strong R. Gastrointestinal angiodysplasia: diagnosis and management. Gastrointest Endosc Clin N Am 2017; 27: 51-62
212 Despott EJ, Fraser C. Small bowel endoscopy in inflammatory bowel disease. Best Pract Res Clin Gastroenterol 2012; 26: 279-291
213 Pape UF, Perren A, Niederle B. et al. ENETS consensus guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas. Neuroendocrinology 2012; 95: 135-156
214 Messer I, May A, Manner H. et al. Prospective, randomized, single-center trial comparing double-balloon enteroscopy and spiral enteroscopy in patients with suspected small bowel disorders. Gastrointest Endosc 2013; 77: 241-249
215 Teshima CW, Aktas H, van Buuren HR. et al. Retrograde double balloon enteroscopy: comparing performance of solely vs. combined same-day anterograde and retrograde procedure. Scand J Gastroenterol 2011; 36: 220-226
216 May A, Nachbar L, Schneider M. et al. Push-and-pull enteroscopy using the double-balloon technique: method of assessing depth of insertion and training of the enteroscopy. Endoscopy 2005; 37: 66-70
217 Zhong J, Ma T, Zhang C. et al. A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel diseases. Endoscopy 2007; 39: 208-215
218 Lopez AO, Soria F, Perez Cuadrado E. et al. Validity of insertion depth measurement in double-balloon endoscopy. Endoscopy 2012; 44: 1045-1050
219 Efthymiou M, Desmond PV, Brown G. et al. SINGLE-01: a randomized, controlled trial comparing the efficacy and depth of insertion of single- and double-balloon enteroscopy by using a novel method to determine insertion depth. Gastrointest Endosc 2012; 76: 972-980
220 Li XB, Chen HM, Zhuang J. et al. A novel modality for the estimation of the enteroscope insertion depth during double-balloon enteroscopy. Gastrointest Endosc 2010; 72: 999-1005
221 Manno M, Barbera C, Bertani H. et al. Single balloon enteroscopy: technical aspects and clinical applications. World J Gastrointest Endosc 2012; 4: 28-32
222 Akerman P, Agrawal D, Cantero D. et al. Spiral enteroscopy with the new DSB overtube: a novel technique for deep peroral small bowel intubation. Endoscopy 2008; 40: 974-978
223 Domagk D, Mensink P, Aktas H. et al. Single- vs. double-balloon enteroscopy in small bowel diagnostics: a randomized multicenter trial. Endoscopy 2011; 43: 472-476
224 Takano N, Yamada A, Watabe H. et al. Single-balloon vs. double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011; 73: 734-739
225 Wadhwa V, Sethi S, Tewani S. et al. A meta-analysis on efficacy and safety: single-balloon vs. double-balloon enteroscopy. Gastroenterol Rep 2015; 3: 148-155
226 Lipka S, Rabbanifard R, Kumar A. et al. Single vs. double balloon enteroscopy for small bowel diagnostics: a systematic review and meta-analysis. J Clin Gastroenterol 2015; 49: 177-184
227 Lenz P, Domagk D. Double- vs. single-balloon vs. spiral enteroscopy. Best Pract Res Clin Gastroenterol 2012; 26: 303-313
228 Despott EJ, Murino A, Bourikas L. et al. A prospective comparison of performance during back-to-back, anterograde manual spiral enteroscopy and double-balloon enteroscopy. Dig Liver Dis 2015; 47: 395-400
229 May A, Manner H, Aschmoneit I. et al. Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small bowel vascular malformations. Endoscopy 2011; 43: 477-483
230 May A, Farber M, Aschmoneit I. et al. Prospective multicenter trial comparing push-and-pull enteroscopy with the single- and double-balloon techniques in patients with small bowel disorders. Am J Gastroenterol 2010; 105: 575-581
231 May A. Double-balloon enteroscopy. Gastrointest Endosc Clin N Am 2017; 27: 113-122
232 Lenz P, Domagk D. Single-balloon enteroscopy. Gastrointest Endosc Clin N Am 27: 123-131
233 Tee HP, How SH, Kaffes AJ. Learning curve for double-balloon enteroscopy: findings from an analysis of 282 procedures. World J Gastrointest Endosc 2012; 4: 368-372
234 Mehdizadeh S, Ross A, Gerson L. et al. What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers. Gastrointest Endosc 2006; 64: 740-750
235 Manner H, May A, Pohl J. et al. The impact of fluoroscopy on the outcome of oral double-balloon enteroscopy: results of a randomized trial in 156 patients. Endoscopy 2010; 42: 820-826
236 Lo SK. Technical matters in double balloon enteroscopy. Gastrointest Endosc 2007; 66: S15-S18
237 May A, Nachbar L, Pohl J. et al. Endoscopic interventions in the small bowel using double-balloon enteroscopy: feasibility and limitations. Am J Gastroenterol 2007; 102: 527-535
238 ASGE Technology Committee, Lo SK, Fujii-Lau LL et al. The use of carbon dioxide in gastrointestinal endoscopy. Gastrointest Endosc 2016; 83: 857-865
239 Domagk D, Bretthauer M, Lenz P. et al. Carbon dioxide insufflation improves intubation depth in double-balloon enteroscopy: a randomized, controlled, double-blind trial. Endoscopy 2007; 39: 1064-1067
240 Hirai F, Beppu T, Nishimura T. et al. Carbon dioxide insufflation compared with air insufflation in double balloon enteroscopy: a prospective, randomized, double-blind trial. Gastrointest Endosc 2011; 73: 743-749
241 Lenz P, Meister T, Manno M. et al. CO2 insufflation during single-balloon enteroscopy: A multicenter randomized controlled trial. Endoscopy 2014; 46: 53-58
242 Li X, Zhao YJ, Dai J. et al. Carbon dioxide insufflation improves the intubation depth and total enteroscopy rate in single-balloon enteroscopy: A randomised, controlled, double-blind trial. Gut 2014; 63: 1560-1565
243 Nishizawa T, Suzuki H, Fujimoto A. et al. Effects of carbon dioxide insufflation in balloon-assisted enteroscopy: A systematic review and meta-analysis. United European Gastroenterol J 2016; 4: 11-7
244 Bretthauer M, Thiis-Evensen E, Huppertz-Hauss G. et al. NORCCAP (Norwegian colorectal cancer prevention): a randomised trial to assess the safety and efficacy of carbon dioxide vs. air insufflation in colonoscopy. Gut 2002; 50: 604-607
245 Saito Y, Uraoka T, Matsuda T. et al. A pilot study to assess the safety and efficacy of carbon dioxide insufflation during colorectal endoscopic submucosal dissection with the patient under conscious sedation. Gastrointest Endosc 2007; 65: 537-542
246 Sumanac K, Zealley I, Fox BM. et al. Minimizing postcolonoscopy abdominal pain by using CO2 insufflation: a prospective, randomized, double blind, controlled trial evaluating a new commercially available CO2 delivery system. Gastrointest Endosc 2002; 56: 190-194
247 Bretthauer M, Lynge AB, Thiis-Evensen E. et al. Carbon dioxide insufflation in colonoscopy: safe and effective in sedated patients. Endoscopy 2005; 37: 706-709
248 Soria F, Lopez-Albors O, Morcillo E. et al. Carbon dioxide insufflation safety in double-balloon enteroscopy: an experimental animal study. Dig Endosc 2013; 25: 39-46
249 Anderson JC. Water-aided colonoscopy. Gastrointest Endosc Clin N Am 2015; 25: 211-226
250 Hafner S, Zolk K, Radaelli F. et al. Water infusion vs. air insufflation for colonoscopy. Cochrane Database Syst Rev 2015; 26: CD009863
251 Cadoni S, Falt P, Rondonotti E. et al. Water exchange for screening colonoscopy increases adenoma detection rate: a multicenter, double-blinded, randomized controlled trial. Endoscopy 2017; 49: 456-467
252 Liang S, Pan Y, Wang B. et al. Water exchange method improves the total examination rate of single balloon enteroscopy: a prospective, randomized, controlled trial. Gastrointest Endosc 2016; 83: AB161-AB162
253 Westwood DA, Alexakis N, Connor SJ. Transparent cap-assisted colonoscopy vs. standard adult colonoscopy: a systematic review and meta-analysis. Dis Colon Rectum 2012; 55: 218-225
254 Sanchez-Yague A, Kaltenbach T, Yamamoto H. et al. The endoscopic cap that can (with videos). Gastrointest Endosc 2012; 76: 169-178
255 Dufault DL, Brock AS. Cap-assisted retrograde single-balloon enteroscopy results in high terminal ileal intubation rate. Endosc Int Open 2016; 4: E202-E204
256 Misra SP, Dwivedi M. Role of intravenously administered hyoscine butyl bromide in retrograde terminal ileoscopy: a randomized, double-blinded, placebo-controlled trial. World J Gastroenterol 2007; 13: 1820-1823
257 Ell C, May A, Nachbar L. et al. Push-and-pull enteroscopy in the small bowel using the double-balloon technique: results of a prospective European multicenter study. Endoscopy 2005; 37: 613-616
258 Heine GD, Hadithi M, Groenen MJ. et al. Double-balloon enteroscopy: indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease. Endoscopy 2006; 38: 42-48
259 Sun B, Rajan E, Cheng S. et al. Diagnostic yield and therapeutic impact of double-balloon enteroscopy in a large cohort of patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2006; 101: 2011-2015
260 Ramchandani M, Reddy DN, Gupta R. et al. Diagnostic yield and therapeutic impact of single-balloon enteroscopy: series of 106 cases. J Gastroenterol Hepatol 2009; 24: 1631-1638
261 Aktas H, de Ridder L, Haringsma J. et al. Complications of single-balloon enteroscopy: a prospective evaluation of 166 procedures. Endoscopy 2010; 42: 365-368
262 Frantz DJ, Dellon ES, Grimm I. et al. Single-balloon enteroscopy: results from an initial experience at a U.S. tertiary-care center. Gastrointest Endosc 2010; 72: 422-426
263 Upchurch BR, Sanaka MR, Lopez AR. et al. The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures. Gastrointest Endosc 2010; 71: 1218-1223
264 Morgan D, Upchurch BR, Draganov PV. et al. Spiral enteroscopy: prospective multicenter U.S. trial in patients with small bowel disorders. Gastrointest Endosc 2010; 72: 992-998
265 Hartmann D, Schmidt H, Bolz G. et al. A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc 2005; 61: 826-832
266 Despott EJ, Gupta A, Burling D. et al. Effective dilation of small bowel strictures by double-balloon enteroscopy in patients with symptomatic Crohn’s disease (with video). Gastrointest Endosc 2009; 70: 1030-1036
267 Despott EJ, Gabe S, Tripoli E. et al. Enteral access by double-balloon enteroscopy: an alternative method of direct percutaneous endoscopic jejunostomy placement. Dig Dis Sci 2011; 56: 494-498
268 Gómez V, Petersen BT. Endoscopic retrograde cholangiopancreatography in surgically altered anatomy. Gastrointest Endosc Clin N Am 2015; 25: 631-656
269 Ishii K, Itoi T, Tonozuka R. Balloon enteroscopy-assisted ERCP in patients with Roux-en-Y gastrectomy and intact papillae (with videos). Gastrointest Endosc 2016; 83: 377-386
270 May A. How to approach the small bowel with flexible enteroscopy. Gastroenterol Clin North Am 2010; 39: 797-806
271 Finkelstone L, Wolf E, Stein MW. Etiology of small bowel thickening on computed tomography. Can J Gastroenterol 2012; 26: 897-901
272 Fraser C, Despott EJ. Peutz–Jeghers syndrome. In: Keuchel M, Hagenmüller F, Hisao T. , eds. Video capsule endoscopy: a reference guide and atlas. Dordrecht: Springer Science and Business Media; 2014
273 Despott EJ, Fraser C. Capsule endoscopy in polyposis syndromes. In: Zhao-Shen L, Zhuan L, McAlindon M. , eds. Handbook of capsule endoscopy. Dordrecht: Springer Science and Business Media; 2014
274 Pohl J, May A, Nachbar L. et al. Diagnostic and therapeutic yield of push-and-pull enteroscopy for symptomatic small bowel Crohn’s disease strictures. Eur J Gastroenterol Hepatol 2007; 19: 529-534
275 Sunada K, Yamamoto H, Yano T. et al. Advances in the diagnosis and treatment of small bowel lesions with Crohn’s disease using double-balloon endoscopy. Therap Adv Gastroenterol 2009; 2: 357-366
276 Thienpont C, D’Hoore A, Vermeire S. et al. Long-term outcome of endoscopic dilatation in patients with Crohn’s disease is not affected by disease activity or medical therapy. Gut 2010; 59: 320-324
277 Beaulieu D, Barkun AN, Dubé C. et al. Endoscopy reporting standards. Can J Gastroenterol 2013; 27: 286-292
278 Rizk MK, Sawhney MS, Cohen J. et al. Quality indicators common to all GI endoscopic procedures. Gastrointest Endosc 2015; 81: 3-16
279 Bretthauer M, Aabakken L, Dekker E. et al. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2016; 48: 291-294
280 Veitch AM, Vanbiervliet G, Gershlick AH. et al. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy 2016; 48: 385-402
281 Itaba S, Nakamura K, Aso A. et al. Prospective, randomized, double-blind, placebo-controlled trial of ulinastatin for prevention of hyperenzymemia after double balloon endoscopy via the antegrade approach. Dig Endosc 2013; 25: 421-427
282 Groenen MJ, Moreels TG, Orlent H. et al. Acute pancreatitis after double-balloon enteroscopy: an old pathogenetic theory revisited as a result of using a new endoscopic tool. Endoscopy 2006; 38: 82-85
283 Matsushita M, Shimatani M, Uchida K. et al. Mechanism of acute pancreatitis after peroral double-balloon enteroscopy. Endoscopy 2007; 39: 480
284 Latorre R, Soria F, Lopez-Albors O. et al. Effect of double-balloon enteroscopy on pancreas: an experimental porcine model. World J Gastroenterol 2012; 18: 5181-5187
285 Honda K, Itaba S, Mizutani T. et al. An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: an association with the development of pancreatitis. Endoscopy 2006; 38: 1040-1043
286 European Section and Board of Gastroenterology and Hepatology. The Blue Book. Available at: http://www.eubogh.org/blue-book/ Accessed: March 2017
287 ASGE Training Committee 2011–2012, Rajan EA, Pais SA et al. Small-bowel endoscopy core curriculum. Gastrointest Endosc 2013; 77: 1-6
288 Sidhu R, Sanders DS, Morris AJ. et al. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut 2008; 57: 125-136

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