Department of Medicine, Jichi Medical University, Tochigi, Japan.
Gastrointest Endosc. 2010 Feb;71(2):287-94. doi: 10.1016/j.gie.2009.08.010. Epub 2009 Nov 14.
Although double-balloon enteroscopy (DBE) is performed increasingly often in adults, few findings are available on the use of DBE in pediatric patients in the published literature.
The aim of our study was to evaluate the safety and efficacy of DBE in pediatric patients.
A retrospective database review.
A database analysis was performed on all pediatric patients (18 years old or younger) who underwent DBE at the Jichi Medical University Hospital between September 2000 and October 2008 selected from a total of 825 patients.
Clinical utility and safety of DBE in pediatric patients.
A total of 92 procedures were performed in 48 patients (27 male, 21 female) with a median age (range) of 12.2 (4-18) years. DBE was performed with the patients under general anesthesia in 43 procedures and under moderate sedation in 49 procedures. The most common indication for DBE was treatment of a stricture of a biliary anastomosis after living-donor liver transplantation with establishment of Roux-en-Y hepaticojejunostomy (23 patients). Endoscopic retrograde cholangiography using DBE was performed, and endoscopic therapy could be performed successfully in 13 (56%) patients. The second most common indication was obscure GI bleeding (10 patients); the lesions responsible for the bleeding were found in 7 (70%) patients. Other indications included surveillance and treatment of hereditary polyposis syndromes (5 patients), abdominal pain (4 patients), and inflammatory bowel disease (2 patients). The overall diagnostic yield was 65% (31 of the 48 patients). Postpolypectomy bleeding occurred in 1 case, but no other complications such as perforation and pancreatitis were observed.
Small number of patients, participation bias, and single center's experience.
DBE is a safe and clinically useful endoscopic procedure in pediatric patients.
虽然双气囊内镜（DBE）在成人中越来越多地应用，但在已发表的文献中，很少有关于在儿科患者中使用 DBE 的资料。
我们的研究旨在评估 DBE 在儿科患者中的安全性和有效性。
回顾性数据库研究。
对 2000 年 9 月至 2008 年 10 月期间在日本顺天堂大学医院接受 DBE 的所有儿科患者（18 岁或以下）进行了数据库分析，这些患者来自总共 825 例患者。
DBE 在儿科患者中的临床应用和安全性。
共有 48 例患者（27 例男性，21 例女性）共进行了 92 次 DBE 操作，中位年龄（范围）为 12.2（4-18）岁。43 例患者在全身麻醉下进行 DBE，49 例患者在中度镇静下进行 DBE。DBE 的最常见适应证是活体供肝移植后胆肠吻合口狭窄的治疗，行 Roux-en-Y 胆肠吻合术（23 例）。通过 DBE 进行了内镜逆行胰胆管造影术，13 例（56%）患者能够成功进行内镜治疗。第二常见的适应证是不明原因的胃肠道出血（10 例）；7 例（70%）患者发现了导致出血的病变。其他适应证包括遗传性息肉病综合征的监测和治疗（5 例）、腹痛（4 例）和炎症性肠病（2 例）。总的诊断率为 65%（48 例患者中的 31 例）。1 例患者发生息肉切除术后出血，但未观察到穿孔和胰腺炎等其他并发症。
患者数量少、参与偏倚和单中心经验。
DBE 是一种安全且具有临床应用价值的儿科内镜检查方法。
