Department of Internal Medicine II, Teaching Hospital of the University of Mainz, Wiesbaden, Germany.
Am J Gastroenterol. 2010 Mar;105(3):575-81. doi: 10.1038/ajg.2009.712. Epub 2010 Jan 5.
Double-balloon enteroscopy (DBE) is now an established method for diagnostic and therapeutic small-bowel endoscopy. Single-balloon enteroscopy (SBE) has been introduced to simplify the technique. A prospective randomized study was carried out to compare the two methods.
The study included 100 patients (50 in each group; 63 men, 37 women; mean age 55 years), with no previous small-bowel or colon surgery. The indications for enteroscopy were (suspected) mid-gastrointestinal bleeding, Crohn's disease, small-bowel masses, chronic diarrhea or abdominal pain or both, and other conditions. Fujinon instruments were used, with either two balloons or one. The end point of the study was complete enteroscopy as the most objective parameter.
No severe complications such as perforation, bleeding, or pancreatitis occurred. Instrument preparation time was significantly faster with SBE than with DBE (P<0.0001). Complete enteroscopy was achieved with the DBE technique in 66% of cases (33 patients), either with the oral route alone or with combined oral and anal approaches. With the SBE technique, the complete enteroscopy rate was significantly lower at 22% (P<0.0001; 11 patients, only with oral and anal routes combined). The rate of therapeutic consequences for the patients based on diagnostic yield and negative complete enteroscopy was significantly higher (P=0.025) in the DBE group at 72%, compared with 48% in the SBE group.
The complete enteroscopy rate was three times higher with DBE than with SBE, accompanied by a higher diagnostic yield. DBE must therefore continue to be regarded as the nonsurgical gold standard procedure for deep small-bowel endoscopy.
双气囊小肠镜（DBE）现已成为诊断和治疗小肠内镜的一种成熟方法。单气囊小肠镜（SBE）的出现简化了该技术。我们进行了一项前瞻性随机研究，比较了这两种方法。
该研究纳入了 100 例患者（每组 50 例；63 名男性，37 名女性；平均年龄 55 岁），均无小肠或结肠手术史。小肠镜检查的适应证为（疑似）中消化道出血、克罗恩病、小肠肿块、慢性腹泻或腹痛或两者兼有、以及其他情况。我们使用 Fujinon 器械，采用双气囊或单气囊。研究的终点是作为最客观参数的全小肠镜检查。
无严重并发症发生，如穿孔、出血或胰腺炎。SBE 的器械准备时间明显快于 DBE（P<0.0001）。DBE 技术以 66%（33 例）的成功率完成全小肠镜检查，仅经口或经口-肛联合途径。SBE 技术的全小肠镜检查成功率明显较低，为 22%（P<0.0001；11 例，仅经口-肛联合途径）。根据诊断结果和阴性全小肠镜检查，DBE 组的患者有更高的治疗效果（P=0.025），达 72%，而 SBE 组为 48%。
DBE 组的全小肠镜检查成功率是 SBE 组的三倍，且诊断率更高。因此，DBE 必须继续被视为非手术性小肠深部内镜检查的金标准。
