Nakayama Sayoko, Tominaga Kazunari, Obayashi Tomoko, Okamoto Junichi, Minamino Hiroaki, Ominami Masaki, Fukunaga Shusei, Nagami Yasuaki, Sugimori Satoshi, Machida Hirohisa, Okazaki Hirotoshi, Sogawa Mitsue, Yamagami Hirokazu, Tanigawa Tetsuya, Watanabe Kenji, Watanabe Toshio, Fujiwara Yasuhiro, Arakawa Tetsuo
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Dig Liver Dis. 2014 Aug;46(8):706-9. doi: 10.1016/j.dld.2014.03.016. Epub 2014 Apr 29.
There are few comprehensive reports detailing the prevalence of major adverse events associated with a double-balloon enteroscopy procedure.
We retrospectively investigated the prevalence of major adverse events in 538 patients (262 males and 276 females; median age, 65 years; age range, 12-95 years) who underwent double-balloon enteroscopy at our Institution between April 2008 and October 2011.
Of the 17 adverse events recorded (3.2%), acute pancreatitis (n=5; 0.9%) occurred during both diagnostic (n=3) and therapeutic (n=2) anterograde double-balloon enteroscopy, and all of them were treated conservatively. For these cases, the average duration of the examination was 135 min, which was longer than for the other patients (97 min) (P=0.046). Intestinal bleeding (1.3%) was observed in 6 cases after endoscopic polypectomy and in 1 case following a biopsy procedure during a diagnostic double-balloon enteroscopy. The prevalence rates of intestinal perforation and other complications were 0.2% and 0.7%, respectively.
The rate of adverse events associated with double-balloon enteroscopy was high compared to that associated with conventional upper/lower gastrointestinal endoscopy (0.042%/0.078%). The occurrence of acute pancreatitis may be significantly dependent on the duration of double-balloon enteroscopy examination.
很少有全面的报告详细说明双气囊小肠镜检查相关主要不良事件的发生率。
我们回顾性调查了2008年4月至2011年10月期间在我院接受双气囊小肠镜检查的538例患者(男性262例,女性276例;中位年龄65岁;年龄范围12 - 95岁)主要不良事件的发生率。
记录的17例不良事件(3.2%)中,急性胰腺炎(n = 5;0.9%)在诊断性(n = 3)和治疗性(n = 2)顺行双气囊小肠镜检查期间均有发生,所有病例均采用保守治疗。对于这些病例,检查的平均时长为135分钟,长于其他患者(97分钟)(P = 0.046)。内镜下息肉切除术后6例出现肠道出血(1.3%),诊断性双气囊小肠镜检查活检术后1例出现肠道出血。肠道穿孔和其他并发症的发生率分别为0.2%和0.7%。
与传统上/下消化道内镜检查(0.042%/0.078%)相比,双气囊小肠镜检查相关不良事件的发生率较高。急性胰腺炎的发生可能与双气囊小肠镜检查的时长显著相关。