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Double-balloon endoscopy in the diagnosis and management of GI tract diseases:Methodology,indications,safety,and clinical impact

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World Journal of Gastroenterology 2006年第47期12卷 7654-7659页

作者： Kazuya Akahoshi Masaru Kubokawa Masahiro Matsumoto Shingo Endo Yasuaki Motomura Jiro Ouchi mitsuhide kimura Atsuhiko Murata Michiaki Murayama Department of Gastroenterology Aso Iizuka Hospital Iizuka 820-8505 Japan

AIM： To prospectively evaluate the indications, methodology, safety, and clinical impact of double-balloon endoscopy. METHODS： A total of 60 patients with suspected or documented small- or large-bowel diseases were investigated by double balloon endoscopy. A total of 103 procedures were performed （42 from the oral route, 60 from the anal route, and 1 from the stoma route）. The main outcome measurements were the time of insertion and the entire examination, complications, diagnostic yields, and the ability to successfully perform treatment. RESULTS： Observation of the entire small intestine was possible in 10 （40%） of 25 patients with total enteroscopy. The median insertion time was 122 min （range, 74-199 min）. Observation of the entire colon was possible in 13 （93%） of 14 patients at＂cer failure of total colonoscopy using a conventional colonoscope. Small-intestine abnormalities were found in 20 （43%） of 46 patients with indications of suspected or documented small bowel diseases, obscure GI tract bleeding, or a history of ileus. Endoscopic procedures including tattooing （n = 33）, bite biopsy （n = 17）, radiographic examination （n = 7）, EUS （n = 5）, hemostasis （n = 1）, polypectomy （n = 5）, balloon dilatation （n = 1）, endoscopic mucosal resection （n = 1） and lithotripsy （n = 1） were all successfully performed. No relevant technical problems or severe complications were encountered. CONCLUSION： Double balloon endoscopy is a feasible technique that allows adequate small and large bowel examination and potentially various endoscopic procedures of small-intestinal lesions. It is safe, useful, and also provides a high clinical impact.

关键词： Double-balloon endoscopy GI tract disease Endoscopic therapy

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Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis

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World Journal of Gastroenterology 2006年第13期12卷 2086-2088页

作者： Hirotada Akiho Yorinobu Sumida Kazuya Akahoshi Atsuhiko Murata Jiro Ouchi Yasuaki Motomura Taisuke Toyomasu mitsuhide kimura Masaru Kubokawa Masahiro Matsumoto Shingo Endo Kazuhiko Nakamura Division of Gastroenterology Aso Iizuka Hospital JapanDepartment of Medicine and Bioregulatory ScienceGraduate School of Medical SciencesKyushu UniversityJapan Division of Gastroenterology Aso Iizuka Hospital Japan Division of Surgery Aso Iizuka Hospital Japan Division of Qastroenterology Aso Iizuka Hospital Japan Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu UniversityJapan

AIM： To evaluate whether an automatically controlled cut system （endocut mode） could reduce the complication rate of endoscopic sphincterotomy （EST） and serum hyperamylasemia after EST compared to the conventional blended cut mode. METHODS： From January 2001 to October 2003, 134 patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure. RESULTS： Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group （9%）： hyperamylasemia （5 times higher than normal） in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group （16%）： hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST （P〈0.02）. The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group （P〈 0.05）. CONCLUSION： Endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.

关键词： Endocut mode Endoscopic sphincterotomy Choledocholithiasis

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