Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8073
Peer-review started: July 20, 2017
First decision: September 4, 2017
Revised: September 17, 2017
Accepted: October 17, 2017
Article in press: October 17, 2017
Published online: December 7, 2017
Processing time: 137 Days and 8.2 Hours
To evaluate the therapeutic role of double-balloon enteroscopy (DBE) in small bowel strictures and to propose a standard approach to small bowel strictures.
Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded.
In total 13 studies were included, in which 310 patients were dilated. The average follow-up time was 31.8 mo per patient. The complication rate was 4.8% per patient and 2.6% per dilatation. Surgery was avoided in 80% of patients. After the first dilatation, 46% were treated with re-dilatation and only 17% required surgery.
DBE-assisted dilatation avoids surgery in 80% of patients with small bowel strictures and is safe and effective. We propose a standardized approach to small bowel strictures.
Core tip: At present there is a wealth of literature on the value of double-balloon enteroscopy (DBE) in the management of obscure gastrointestinal bleeding. However, there is only few data regarding its role in small bowel strictures and these patients often face surgery. In our study we show that DBE-assisted endoscopic balloon dilation offers safe and effective treatment of small bowel strictures. Surgery can be avoided in 80% of cases. Moreover, we propose a flow-chart representing a standard approach to small bowel strictures.