Small bowel intervention and application of enteroscopy for altered small bowel anatomy—endoscopic advanced therapy using double balloon enteroscopy

The management of patients with small bowel obstruction distal to the third part of the duodenum and altered gastrointestinal anatomy is challenging. Until recently, surgery had been the mainstay of treatment for obstruction, which had however posed a risk of serious complications. The difficulty with the endoscopic approach in the deep area of the intestine and the blind end of the altered gastrointestinal anatomy could be a possible reason. Recently, the advent of overtube-assisted endoscopy has radically facilitated endoscopic interventions such as balloon dilation for benign obstructions or placement of self-expanding metal stents for malignant obstructions. Advanced endoscopic therapy for small bowel stricture or choledochojejunal anastomotic stricture has become a safe and effective method.