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World J Gastroenterol. Feb 7, 2008; 14(5): 720-724
Published online Feb 7, 2008. doi: 10.3748/wjg.14.720
Double balloon endoscopy associated pancreatitis: A description of six cases
Soeresh VA Jarbandhan, Stijn JB van Weyenberg, Willem M van der Veer, Dimitri GN Heine, Chris JJ Mulder, Maarten AJM Jacobs
Soeresh VA Jarbandhan, Stijn JB van Weyenberg, Willem M van der Veer, Dimitri GN Heine, Chris JJ Mulder, Maarten AJM Jacobs, Small Bowel Unit, Department of Gastroenterology, VU University Medical Center Amsterdam, The Netherlands
Correspondence to: Soeresh VA Jarbandhan, MD, Small Bowel Unit, Department of Gastroenterology, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. v.jarbandhan@vumc.nl
Telephone: +31-20-4440613
Fax: +31-20-4440554
Received: August 14, 2007
Revised: October 25, 2007
Published online: February 7, 2008
Abstract

AIM: To perform a single-center analysis of all double balloon endoscopy (DBE) related cases of pancreatitis identified prospectively from a recorded DBE-complication database.

METHODS: From November 2003 until January 2007, 603 DBE procedures were performed on 412 patients, with data on complications recorded in a database. The setting was a tertiary care center offering DBE. DBE was performed from the antegrade or retrograde route. Outcome measurements included age, gender, medication, indication, DBE-endoscope type, insertion depth, procedure duration, findings, interventions, post-procedural abdominal pain, and post-procedural hospitalization.

RESULTS: This is the largest single-center study reporting on post-DBE pancreatitis prospectively. Six patients (1.0%) developed post-DBE pancreatitis, all after antegrade DBE. There was no association with gender, duration of the procedure or type of endoscope. The mean age was 51.9 years (range 25-78). Four patients had severe pancreatitis. Of these, two had inflammatory signs in the body-tail region, one had pancreatitis in the tail region, and the total pancreas was involved in one.

CONCLUSION: The incidence of post-DBE pancreatitis in our series is higher than previously reported. We found no relation with DBE-endoscope type. The inflammatory changes occurred in the body-tail region of the pancreas, suggesting that post-DBE pancreatitis is caused by repetitive mechanical strain on the pancreas.

Keywords: Double balloon endoscopy; Small intestine; Adverse events; Complications; Pancreatitis; Enteroscopy