Endoscopy 2021; 53(08): 802-814
DOI: 10.1055/a-1243-0226
Original article

Novel ultrathin double-balloon endoscopy for the diagnosis of small-bowel diseases: a multicenter nonrandomized study

Masanao Nakamura
1   Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Tomonori Yano
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Motohiro Esaki
3   Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Shiro Oka
4   Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Keigo Mitsui
5   Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
,
Fumihito Hirai
6   Inflammatory Bowel Disease Center, Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
7   Department of Gastroenterology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
,
Keisuke Kawasaki
8   Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
,
Mitsuhiro Fujishiro
1   Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Takehiro Torisu
3   Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Shinji Tanaka
4   Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Katsuhiko Iwakiri
5   Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
,
Masahiro Kishi
6   Inflammatory Bowel Disease Center, Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
,
Takayuki Matsumoto
8   Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
,
Hironori Yamamoto
2   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
› Author Affiliations
Trial Registration: University Hospital Medical Network Clinical Trials Registry Registration number (trial ID): UMIN000015836 Type of study: Prospective, multi-center study


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Abstract

Background This study aimed to compare the markers of potential pancreatic injury during antegrade double-balloon endoscopy (DBE) using the newly developed ultrathin EN-580XP system and the conventional EN-580T system.

Methods Patients who were scheduled for antegrade DBE during daily clinical practice were enrolled. Clinical background, adverse events, and laboratory data of patients were compared between those who underwent endoscopy using the EN-580XP system and those in whom the EN-580T system was used. The primary end points were pancreatic hyperamylasemia and hyperlipasemia after DBE.

Results A total of 295 cases were registered. Pancreatic hyperamylasemia occurred in 2 of 92 patients (2.2 %) in the EN-580XP group and in 28 of 147 patients (19.1 %) in the EN-580 T diagnosis group (P < 0.001). Hyperlipasemia was significantly different between the two groups (1.1 % [EN-580XP] vs. 13.6 % [EN-580 T diagnosis]; P < 0.001). Acute pancreatitis occurred in four patients (7.1 %) in the EN-580 T therapy group. Multiple logistic regression analyses revealed that the endoscope type EN-580 T was significantly associated with pancreatic hyperamylasemia (adjusted odds ratio [OR] 8.63, 95 % confidence interval [CI] 1.97 – 37.70; P < 0.01) and hyperlipasemia (adjusted OR 13.10, 95 %CI 1.70 – 100.70; P = 0.01).

Conclusions The EN-580XP system seemed less harmful to the pancreas during antegrade DBE.

Supplementary material



Publication History

Received: 27 October 2019

Accepted: 16 July 2020

Article published online:
09 September 2020

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