双气囊肠镜的欧洲经验:适应证、方法学、安全性及临床意义

作     者：Di Caro S. May A. Heine D.G.N. A. Gasbarrini 徐瑞 

作者机构：Department of Internal Medicine Catholic University of Rome Largo Gemelli 1 00168 Rome Italy Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第2期

页      面：41-41页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：小肠疾病 乳糜泻 克罗恩病 经口 治疗工具 消化道出血 大便隐血试验 回盲瓣 血管扩张 诊断率 

摘      要：Background: Double-balloon enteroscopy (DBE) is a new technique that allows high-resolution visualization, biopsies, and therapeutic interventions in all segments of the GI tract. The objective of the study was to evaluate the indications, the safety, and the clinical impact of DBE. Methods: This is a retrospective analysis conducted at 4 European medical centers. A total of 62 patients with suspected or documented small-bowel diseases were investigated by DBE. A total of 89 procedures were performed (26 and 9 patients from the oral or the anal route, respectively; 27 patients from both). The main outcome measurements were complications, depth and time of insertion, diagnostics, and therapeutics rates. Results: No complications occurred. Mean time was 70 ± 30 minutes and 90 ± 35 minutes from the oral and the anal route, respectively. Length of insertion was 254 ± 174 cm beyond the pylorus, 180 ± 150 cm beyond the ileocecal valve, whereas the entire small bowel was completely explored in 10 patients. DBE was diagnostic in 80% of the patients: in 29 of 33 of patients with GI bleeding, in one of 5 patients with iron deficiency anemia and positive fecal occult blood testing, in 3 of 5 patients with chronic diarrhea, in two of 3 patients with abdominal pain, in two of 3 patients with GI cancer (follow-up), in all patients with suspected or refractory celiac disease, and in two of 3 patients with Crohn’s disease. Treatment was performed in 41.9% of patients (22 polyps and 29 angioectesias). Conclusions: DBE is a safe and feasible diagnostic and therapeutic tool for suspected or documented small-bowel diseases. At present, the best candidates for the procedure appear to be those with obscure GI bleeding.