Effect of the manipulation of the duodenal papilla during double balloon enteroscopy

Table 1 Evaluation of pancreatic lesions

Parameter/lesion	Grade 0	Grade 1	Grade 2	Grade 3
Edema	Absent	Diffuse dilation of interlobular septi	Diffuse dilation of interacinous space	Diffuse dilation of intercellular space
Vacuolization	Absent	Focal (< 25%)	Diffuse (25%-50%)	Severe (> 50%)
Necrosis	Absent	< 50% lobules	50%-75% lobules	> 75% lobules
Vessels congestion	Absent	Focal (< 25%)	Diffuse (25%-50%)	Severe (> 50%)
Inflammation	Absent	< 50% lobules	50%-75% lobules	> 75% lobules

Table 2 Within group comparison of serum levels (mean ± SD) of biochemical markers (amylase, lipase and CRP) at different sampling points (Basal, End of endoscopy and 24 h later)

Group	Time	Amylase (IU/L)	Lipase (IU/L)	CRP (mg/L)
GP	Basal	2507.9 ± 553.61	34.3 ± 19.261	30.1 ± 43.31
	End	2317 ± 523.52	45.4 ± 33.61	27.4 ± 41.71
	24 h	3993.3 ± 2047.33	444.6 ± 417.22,d	182.3 ± 44.52,d
GP + DBE	Basal	2214.9 ± 385.91	19.6 ± 16.41	20.6 ± 26.41
	End	1920.2 ± 360.82	37.1 ± 29.52,b	16.2 ± 21.81
	24 h	2717.2 ± 686.62	146.8 ± 128.11,2	117.3 ± 46.12,d
GDBE	Basal	1968.1 ± 929.61	17.7 ± 7.71	39.1 ± 41.21
	End	1850 ± 820.72	8.8 ± 3.61	37.2 ± 38.31
	24 h	2487.2 ± 1093.42	26.7 ± 20.91	114.8 ± 100.72,d
GC	Basal	1965.4 ± 856.41	10.7 ± 3.11	9.8 ± 8.81
	End	1881.9 ± 839.51	9.1 ± 2.321	10.1 ± 8.31
	24 h	2245.8 ± 995.91	37.5 ± 23.61	24.2 ± 17.41

^1,2,3Different superscripts within the same column of the same experimental group indicate significant differences at 95% confidence (P < 0.05). ^bP < 0.01, ^dP < 0.0001 vs basal. GP: Group papilla; GP + DBE: Group papilla + double balloon enteroscopy; GC: Group control; GDBE: Group DBE.

Table 3 Comparison of histopathological features (mean ± SD) between the GP, GP + DBE groups according to the categorization scale given in Table 1

Group	Edema	Vacuolization	Necrosis	Vessels congestion	Inflammation
GP	3.38 ± 0.66	2.95 ± 0.831	1.59 ± 0.751	0.89 ± 0.44	0.21 ± 0.51
GP + DBE	3.29 ± 0.64	2.56 ± 0.97	1.32 ± 0.75	0.93 ± 0.41	0.21 ± 0.56

¹The existence of significant differences at 95% significance level. Control group is not included, as it had no lesions. Group DBE (GDBE) is also not included because the histological assessment was performed at 7 d after procedure[19]. GP: Group papilla; DBE: Double balloon enteroscopy.

Table 4 Significance levels for the χ² test of association between the experimental procedures (GP, GP + DBE) and the frequency of damaged samples

Histopathological parameter	P value
Edema	0.73
Vacuolization	0.061
Necrosis	0.091
Vessels congestion	0.80
Inflammation	0.46

¹The existence of a significantly different frequency of damaged samples in GP and GP + DBE for each histopathological parameter for a 90% confidence (P < 0.1).