Indications, detectability, positive findings, total enteroscopy, and complications of diagnostic double-balloon endoscopy: a systematic review of data over the first decade of use - 27/08/11
, Zhuan Liao, MD a, ⁎, Yue-Ping Jiang, MD b, , Zhao-Shen Li, MD a, ⁎Reprint requests: Dr Zhuan Liao or Professor Zhao-Shen Li, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, ChinaRiassunto |
Background |
Double-balloon endoscopy (DBE) has been used in clinical practice for nearly 10 years.
Objective |
To systematically collect and produce pooled data on indications, detection rate, total enteroscopy, complications, and the composition of positive findings in diagnostic DBE.
Design |
A systematic review.
Main Outcome Measurements |
We searched PubMed between January 1, 2001 and March 31, 2010 for original articles about DBE evaluation of small-bowel diseases. Data on total number of procedures, distribution of indications, pooled detection rate, pooled total enteroscopy rate, and composition of positive findings were extracted and/or calculated. In addition, the data involving DBE-associated complications were analyzed.
Results |
A total of 66 English-language original articles involving 12,823 procedures were included. Suspected mid-GI bleeding (MGIB) was the most common indication (62.5%), followed by symptoms/signs only (7.9%), small-bowel obstruction (5.8%), and Crohn's disease (5.8%). The pooled detection rates were 68.1%, 68.0%, 53.6%, 63.4%, and 85.8% for overall, suspected MGIB, symptoms/signs only, Crohn's disease, and small-bowel obstruction, respectively. Inflammatory lesions (37.6%) and vascular lesions (65.9%) were the most common findings, respectively, in suspected MGIB patients of Eastern and Western countries. The pooled total enteroscopy rate was 44.0% by combined or antegrade-only approach. The pooled minor and major complication rates were 9.1% and 0.72%, respectively.
Limitations |
Inclusion and exclusion criteria were loosely defined.
Conclusion |
The detectability and complication risk of diagnostic DBE are acceptable. Suspected MGIB is the most common indication, with a relatively high detection rate, but there was a difference in its causes between Western and Eastern countries.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : DBE, MGIB
Mappa
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact Dr Liao at zhuanliao@hotmail.com or Dr Li at zhaoshenli@hotmail.com. |
Vol 74 - N° 3
P. 563-570 - settembre 2011 Ritorno al numero
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