Double-balloon endoscopy in the diagnosis and management of GI tract diseases: Methodology, indications, safety, and clinical impact

Table 1 Indications for and the clinical Impact of DBE

Indications	DBE diagnosis	n (%)	Clinical impact
Suspected or documented small bowel diseases		24 (40)
	Crohn’s disease	5 (8)	Medical and Endoscopic treatment
	Jejunal cancer	2 (3)	Surgical treatment
	Malignant lymphoma	1 (1.7)	Medical treatment
	Enterolithiasis	1 (1.7)	Endoscopic treatment
	Peutz-Jeghers syndrome	1 (1.7)	Endoscopic treatment
	Intestinal Behçet disease	1 (1.7)	Medical treatment
	Cronkhite-Canada syndrome	1 (1.7)	Medical treatment
	Jejunal lipoma	1 (1.7)	No treatment
	NSAIDs ulcers	1 (1.7)	Medical treatment
	Stomal ulcer	1 (1.7)	Medical treatment
	Negative findings	9 (15)	Symptomatic approaches
Obscure GI tract bleeding		20 (33)
	Ileal angiodysplasia	1 (1.7)	Endoscopic treatment
	Jejunal cancer	1 (1.7)	Surgical treatment
	NSAIDs ulcer	1 (1.7)	Medical treatment
	Solitary Peutz-Jeghers type polyp	1 (1.7)	Surgical treatment
	Idiopathic small intestinal ulcer	1 (1.7)	Medical treatment
	Negative findings	15 (25)	Follow-up
Incomplete conventional colonoscopy		14 (23)
	Colonic polyp	5 (8)	Endoscopic treatment
	Colonic diverticula	3 (5)	Synmptomatic approaches
	Colonic cancer	1 (1.7)	Surgical treatment
	Colonic submucosal tumor	1 (1.7)	Follow-up
	Colonic tuberculosis	1 (1.7)	Medical treatment
	Negative findings	3 (5)	Follow-up
History of ileus		2 (3)
	Negative findings	2 (3)	Follow-up

Table 2 Clinical data of patients who underwent DBE

Indications	Approach	n	Median insertion time (range, min)	Successful insertion
Panenteroscopy	Antegrade + Retrograde	25	122 (74-199)	40% (10/25)
Partial enteroscopy for suspected or documented lesion	Antegrade	9	40 (11-99)	67% (6/9)
	Retrograde	12	55 (10-87)	75% (9/12)
	Total	21	46 (10-99)	71% (15/21)
Total colonoscopy	Retrograde	14	47 (15-78)	93% (13/14)

Table 3 Managements during or after DBE in 60 patients

	n	%
Endoscopic	9	15
Surgical	5	8
Medical	12	20
Symptomatic approaches or follow-up	34	56

Table 4 Endoscopic procedures using DBE

Procedure	n	%
Tattooing	33	55
Biopsy	17	28
Radiographic examination	7	12
EUS	5	8
Polypectomy	5	8
Hemostasis	1	2
Balloon dilation	1	2
Lithotripsy	1	2
Endoscopic mucosal resection	1	2