Mensink P B F, Haringsma J, Kucharzik T, Cellier C, Pérez-Cuadrado E, Mönkemüller K, Gasbarrini A, Kaffes A J, Nakamura K, Yen H H, Yamamoto H
Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
Endoscopy. 2007 Jul;39(7):613-5. doi: 10.1055/s-2007-966444. Epub 2007 May 21.
Double balloon enteroscopy (DBE) is a new technique for the visualization of the small bowel. Although the technique is widely used, little is known about the complications. A few complications have been reported in the literature, mainly in case reports. The aim of this study was to establish the complication rate of both diagnostic and therapeutic DBE.
A total of 10 centers (nine academic centers and one teaching hospital) across four continents participated in the study. Complications were defined according to the literature. A therapeutic DBE was defined as a DBE with use of argon plasma coagulation, a polypectomy snare, injection of fluids (other than ink for marking), removal of foreign body, or balloon dilation.
A total 85 adverse events were reported in 2362 DBE procedures. In all, 40 events fulfilled the definition of a complication, 13 in 1728 diagnostic DBE (0.8 %) and 27 during 634 therapeutic procedures (4.3 %). The complications were rated minor in 21 (0.9 %), moderate in 6 (0.3 %) and severe in 13 procedures (0.6 %). No fatal complications were reported. Seven cases of pancreatitis were reported, six after diagnostic (0.3 %) and one after therapeutic (0.2 %) DBE.
Diagnostic DBE is safe with a low complication rate. The complication rate of therapeutic DBE is high compared with therapeutic colonoscopy. The reason for this is unclear. The incidence of pancreatitis after DBE is low (0.3 %), but has to be considered in patients with persistent abdominal complaints after a DBE procedure.
双气囊小肠镜检查（DBE）是一种用于观察小肠的新技术。尽管该技术已被广泛应用，但对其并发症却知之甚少。文献中仅报道了少数并发症，主要是病例报告。本研究的目的是确定诊断性和治疗性DBE的并发症发生率。
来自四大洲的10个中心（9个学术中心和1个教学医院）参与了本研究。并发症根据文献进行定义。治疗性DBE定义为使用氩等离子体凝固、息肉切除圈套器、注射液体（非用于标记的墨水）、取出异物或球囊扩张的DBE。
在2362例DBE操作中，共报告了85起不良事件。其中，40起事件符合并发症的定义，1728例诊断性DBE中有13例（0.8%），634例治疗性操作中有27例（4.3%）。并发症中，轻度21例（0.9%），中度6例（0.3%），重度13例（0.6%）。未报告致命并发症。报告了7例胰腺炎病例，诊断性DBE后6例（0.3%），治疗性DBE后1例（0.2%）。
诊断性DBE安全，并发症发生率低。与治疗性结肠镜检查相比，治疗性DBE的并发症发生率较高。原因尚不清楚。DBE后胰腺炎的发生率较低（0.3%），但对于DBE操作后持续存在腹部不适的患者必须予以考虑。
