Complications of double balloon enteroscopy: a multicenter survey

P. B. F. Mensink; J. Haringsma; T. Kucharzik; C. Cellier; E. Pérez-Cuadrado; K. Mönkemüller; A. Gasbarrini; A. J. Kaffes; K. Nakamura; H. H. Yen; H. Yamamoto

doi:10.1055/s-2007-966444

Endoscopy 2007; 39(7): 613-615
DOI: 10.1055/s-2007-966444

Original article

Complications of double balloon enteroscopy: a multicenter survey

P. B. F. Mensink¹ , J. Haringsma¹ , T. Kucharzik² , C. Cellier³ , E. Pérez-Cuadrado⁴ , K. Mönkemüller⁵ , A. Gasbarrini⁶ , A. J. Kaffes⁷ , K. Nakamura⁸ , H. H. Yen⁹ , H. Yamamoto¹⁰

¹Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
²Department of Medicine B, University of Muenster, Muenster, Germany
³Department of Gastroenterology, Georges Pompidou European Hospital, Paris, France
⁴Unit of Small Bowel, Section of Digestive Diseases, Hospital General Universitario Morales Meseguer, Murcia, Spain
⁵Division of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg University Hospital, Magdeburg, Germany
⁶Department of Internal Medicine and Endoscopy, Gemelli Hospital, Catholic University, Rome, Italy
⁷Department of Gastroenterology and Hepatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
⁸Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
⁹Department of Gastroenterology, Changhua Christian Medical Center, Changhua, Taiwan
¹⁰Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi, Japan

Abstract

Background and study aims: Double balloon enteroscopy (DBE) is a new technique for the visualization of the small bowel. Although the technique is widely used, little is known about the complications. A few complications have been reported in the literature, mainly in case reports. The aim of this study was to establish the complication rate of both diagnostic and therapeutic DBE. Patients and methods: A total of 10 centers (nine academic centers and one teaching hospital) across four continents participated in the study. Complications were defined according to the literature. A therapeutic DBE was defined as a DBE with use of argon plasma coagulation, a polypectomy snare, injection of fluids (other than ink for marking), removal of foreign body, or balloon dilation. Results: A total 85 adverse events were reported in 2362 DBE procedures. In all, 40 events fulfilled the definition of a complication, 13 in 1728 diagnostic DBE (0.8 %) and 27 during 634 therapeutic procedures (4.3 %). The complications were rated minor in 21 (0.9 %), moderate in 6 (0.3 %) and severe in 13 procedures (0.6 %). No fatal complications were reported. Seven cases of pancreatitis were reported, six after diagnostic (0.3 %) and one after therapeutic (0.2 %) DBE. Conclusions: Diagnostic DBE is safe with a low complication rate. The complication rate of therapeutic DBE is high compared with therapeutic colonoscopy. The reason for this is unclear. The incidence of pancreatitis after DBE is low (0.3 %), but has to be considered in patients with persistent abdominal complaints after a DBE procedure.

Full Text

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P. B. F. Mensink, MD, PhD

Erasmus MC - University Medical Center
Department of Gastroenterology and Hepatology

Dr. Molewaterplein 40
3015 GD Rotterdam
The Netherlands

Fax: +31-10-4634680

Email: p.mensink@erasmusmc.nl