Background and study aims: Double-balloon enteroscopy (DBE) has been suggested to be more efficient if based
on the results of screening video capsule endoscopy (VCE). We evaluated the utility
of VCE for predicting the best insertion route of DBE for the evaluation and treatment
of small-bowel lesions.
Patients and methods: Results of studies of patients with complete VCE examination of the small bowel and
with findings confirmed by DBE are reported. A location index of lesions found on
VCE was defined as the time from the pylorus to the lesion as a percentage of the
time from the pylorus to the ileocecal valve. Based on our previous retrospective
evaluation, a cut-off value of 0.6 was adopted, and the oral or anal approach was
selected when the index was ≤ 0.6 or > 0.6, respectively.
Results: Data from 60 patients who underwent both VCE and DBE examinations and in whom the
capsule reached the cecum were evaluated. Lesions shown on VCE were all reached by
the first DBE procedures (41 orally and 19 anally). Based on the time index cut-off
value of 0.6, the accuracy of selecting the insertion route of DBE was 100 %.
Conclusion: DBE is an effective approach for confirming VCE results. In patients with complete
small-bowel investigation by VCE, the best insertion route for DBE can be reliably
indicated using a time index based on the VCE records.
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Z. GeMD
Department of Gastroenterology
Shanghai Renji Hospital
Shanghai Jiaotong University School of Medicine
Shanghai Institute of Digestive Disease
145 Shan-dong zhong Rd
Shanghai 200001
China
Fax: +86-21-68383015
eMail: zhizhengge@yahoo.com.cn
