Diagnostic yield and safety of double balloon-assisted enteroscopy in the elderly: A systematic review and meta-analysis

AimDouble balloon-assisted enteroscopy (DBE) is commonly used to investigate small bowel diseases. We performed a meta-analysis to assess the diagnostic yield and safety of DBE in the elderly.MethodsWe searched PubMed, Medline, EMBASE, Cochrane Central Register of Controlled Trials, China Academic Journal Network Publishing, Wangfang and Vip citation databases. Data were extracted to evaluate the pooled diagnostic yield and complication rate of DBE in the elderly, the relative diagnostic yield and complication rate of DBE between the elderly patients and the young patients.ResultsWe included 14 studies with 2318 eligible patients undergoing 2677 procedures. Obscure gastrointestinal bleeding was the most common indication (82.2%, 726/883). Angioectasia was the most common detected abnormality (52.4%, 404/771). The pooled diagnostic yield of DBE in the elderly was 0.73 (95% CI: 0.66, 0.81). The relative diagnostic yield of DBE in the elderly compared to the young was 1.76 (95% CI: 1.07, 2.90), P = 0.03. The pooled complication rate of DBE in the elderly was 0.04 (95% CI: 0.02, 0.05). Transient hypoxia was the most common complication of DBE in the elderly (7/805), followed by pancreatitis (5/805). The pooled relative complication rate of DBE in the elderly compared to the young was 1.00 (95% CI: 0.34, 2.91), P = 1.00.ConclusionsOur study shows that the complication rate is not higher in the elderly patients than that in the young patients and the elderly are more likely to have a higher diagnostic yield than the young.