Single-balloon enteroscopy: results from an initial experience at a U.S. tertiary-care center

Background Single-balloon enteroscopy (SBE) is a novel, deep-enteroscopy modality for diagnosis and treatment of disorders of the small bowel. Objective The aim of the study was to examine the performance, yield, and safety of SBE in the initial experience at a tertiary-care center. Design Retrospective analysis of all SBEs during a 10-month period in 2008. Data were extracted from electronic clinical and endoscopy records. Setting U.S. tertiary-care center. Patients All patients referred to our center for SBE during the study period were included in the current analysis. Intervention SBE. Main Outcome Measurements Anterograde SBE procedure time, diagnostic yield, and complications. Results Thirty-eight anterograde SBEs were performed. The mean patient age was 62 years (42% female). Patients were referred for GI bleeding (97%), Crohn's disease, suspected polyps or neoplasia, and abnormal capsule endoscopy results. The mean (± SD) procedure time was 49 ± 19 minutes. The estimated depth of insertion was proximal jejunum (34%), mid-jejunum (45%), and distal jejunum (21%). The SBE diagnostic yield was 47%, with significant findings in 18 patients. Findings included angiectasias, bleeding, abnormal mucosa, ulceration, polyps, and a foreign body. The therapeutic yield was 42%, with lesion ablation performed in 24% of cases. Diagnostic biopsies were performed in 24% of cases and tattooing in 52%. There were no significant complications. Limitations Single-center, retrospective study. Conclusion Single-balloon enteroscopy appears to be a safe and efficient method for examination of the mid-small bowel. The significant therapeutic yield (42%) suggests that comparative studies with double-balloon and spiral enteroscopy are warranted.