The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures

BackgroundSingle-balloon enteroscopy (SBE) is a novel endoscopic technique designed to evaluate and treat small-bowel disease. Although there is substantial literature addressing double-balloon enteroscopy and its impact on the diagnosis and management of small-bowel disease, there are limited data available on the clinical utility of SBE.ObjectivesTo evaluate the clinical utility and diagnostic impact of SBE in a large cohort of patients at a single tertiary center.DesignSingle-center, retrospective study.SettingDigestive Disease Institute, Cleveland Clinic, Cleveland, Ohio.PatientsA total of 161 patients were referred for SBE from January 2006 to August 2008.Main Outcome MeasurementsDemographic, clinical, procedural, and outcome data were collected and analyzed.ResultsA total of 161 patients underwent a total of 172 procedures. Antegrade and retrograde approaches were used in 83% and 17% of subjects, respectively. The average insertion depth using the antegrade approach was 132 cm beyond the ligament of Treitz (range 20-400 cm). The average insertion depth using the retrograde approach was 73 cm above the ileocecal valve (range 10-160 cm). The average procedure time was 40 minutes overall, 38 minutes (range 12-90) antegrade and 48 minutes (range 28-89) retrograde. Fluoroscopy was used in 20 cases (12%). Diagnostic yield was 58% (99/172); 42% (72/172) were therapeutic cases. There were no significant complications.LimitationsSingle-center, retrospective study.ConclusionsSBE demonstrated a high diagnostic yield and frequently provided useful therapeutic intervention. It seems to be a safe and effective method for performing deep enteroscopy.