Baars JE, Theyventhiran R, Aepli P, Saxena P, Kaffes AJ. Double-balloon enteroscopy-assisted dilatation avoids surgery for small bowel strictures: A systematic review. World J Gastroenterol 2017; 23(45): 8073-8081 [PMID: 29259383 DOI: 10.3748/wjg.v23.i45.8073]
Corresponding Author of This Article
Arthur J Kaffes, MBBS, FRACP, Associate Professor, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Suite G10, RPA Medical Centre, 100 Carillon Ave, Camperdown, Sydney NSW 2050, Australia. arthur@kaffes.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Systematic Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 7, 2017; 23(45): 8073-8081 Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8073
Double-balloon enteroscopy-assisted dilatation avoids surgery for small bowel strictures: A systematic review
Judith E Baars, Ruben Theyventhiran, Patrick Aepli, Payal Saxena, Arthur J Kaffes
Judith E Baars, Ruben Theyventhiran, Patrick Aepli, Payal Saxena, Arthur J Kaffes, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Sydney NSW 2050, Australia
Author contributions: Baars JE performed the research and wrote the manuscript, Theyventhiran R and Aepli P collected and reviewed the data; Saxena P and Kaffes AJ managed the study; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Arthur J Kaffes, MBBS, FRACP, Associate Professor, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Suite G10, RPA Medical Centre, 100 Carillon Ave, Camperdown, Sydney NSW 2050, Australia. arthur@kaffes.com
Telephone: +61-295-162033 Fax: +61-295-160778
Received: July 20, 2017 Peer-review started: July 20, 2017 First decision: September 4, 2017 Revised: September 17, 2017 Accepted: October 17, 2017 Article in press: October 17, 2017 Published online: December 7, 2017
Abstract
AIM
To evaluate the therapeutic role of double-balloon enteroscopy (DBE) in small bowel strictures and to propose a standard approach to small bowel strictures.
METHODS
Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded.
RESULTS
In total 13 studies were included, in which 310 patients were dilated. The average follow-up time was 31.8 mo per patient. The complication rate was 4.8% per patient and 2.6% per dilatation. Surgery was avoided in 80% of patients. After the first dilatation, 46% were treated with re-dilatation and only 17% required surgery.
CONCLUSION
DBE-assisted dilatation avoids surgery in 80% of patients with small bowel strictures and is safe and effective. We propose a standardized approach to small bowel strictures.
Core tip: At present there is a wealth of literature on the value of double-balloon enteroscopy (DBE) in the management of obscure gastrointestinal bleeding. However, there is only few data regarding its role in small bowel strictures and these patients often face surgery. In our study we show that DBE-assisted endoscopic balloon dilation offers safe and effective treatment of small bowel strictures. Surgery can be avoided in 80% of cases. Moreover, we propose a flow-chart representing a standard approach to small bowel strictures.
