Jensen Troels Munk, Vilmann Peter, Hendel Jakob W
Gentofte Hospital, Kirurgisk Gastroenterologisk Afdeling D, Hellerup.
Ugeskr Laeger. 2008 Feb 4;170(6):433-7.
Double-balloon endoscopy (DBE) is a novel technique for diagnosis and treatment of small bowel diseases. This study describes the first Danish experiences with DBE.
Retrospective study of 31 consecutive patients examined with DBE at Gentofte Hospital from March 2004 to September 2006.
A total of 42 DBE (32 oral, ten anal) were performed. Insertion-length for the oral and anal DBE was 206 cm (range 40-500 cm) beyond the Ligament of Treitz and 141 cm (range 10-200 cm) beyond the ileo-cecal valve, respectively. Duration was 128 min/124 min (range 55-285 min/60-155 min), respectively. In two patients a total inspection of the small bowel was possible. The diagnostic yield was 74% (CI: 57%-86%) with a therapeutic yield in 21 patients (68% CI: 50%-81%). One major complication with perforation occurred due to improper handling of the endoscope.
DBE is a new effective method for the diagnosis and treatment of small bowel diseases. If used correctly, DBE is safe with few complications. DBE is expected to become an essential endoscopic method for handling small bowel diseases in close conjunction with capsule endoscopy. DBE demands considerable resources and requires experience with advanced endoscopic techniques and hence should be limited to only a few national centres.
双气囊小肠镜检查(DBE)是一种诊断和治疗小肠疾病的新技术。本研究描述了丹麦首例DBE的经验。
对2004年3月至2006年9月在根措夫特医院连续接受DBE检查的31例患者进行回顾性研究。
共进行了42次DBE检查(经口32次,经肛10次)。经口和经肛DBE的插入长度分别为屈氏韧带以远206 cm(范围40 - 500 cm)和回盲瓣以远141 cm(范围10 - 200 cm)。检查时间分别为128分钟/124分钟(范围55 - 285分钟/60 - 155分钟)。两名患者实现了对小肠的全面检查。诊断阳性率为74%(可信区间:57% - 86%),21例患者有治疗效果(68%可信区间:50% - 81%)。因内镜操作不当发生1例穿孔的严重并发症。
DBE是诊断和治疗小肠疾病的一种新的有效方法。如果正确使用,DBE是安全的,并发症少。DBE有望与胶囊内镜密切配合,成为处理小肠疾病的重要内镜检查方法。DBE需要大量资源,且需要先进内镜技术经验,因此应仅限于少数几个国家中心开展。