Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success

doi:10.1016/j.gie.2009.10.054

Gastrointestinal Endoscopy

Volume 71, Issue 6, May 2010, Pages 983-989

Presented at Digestive Disease Week, Poster Presentation, May 31, 2009, Chicago, Illinois (Gastrointest Endosc 2009;69:xxx).

https://doi.org/10.1016/j.gie.2009.10.054 Get rights and content

Background

Double-balloon enteroscopy (DBE) is an important tool in the evaluation and management of small-bowel disease. Limited data are available on the safety, findings, and outcomes of DBE in elderly patients.

Objective

To determine the safety and efficacy of DBE in elderly patients.

Design

Single-center, retrospective analysis of prospectively collected database.

Setting

Open-access, tertiary care referral center.

Patients

A total of 176 patients undergoing DBE (216 procedures) for evaluation of small-bowel disease between August 2007 and August 2008.

Interventions

Argon plasma coagulation of bleeding small-bowel lesions.

Main Outcome Measurements

DBE complication rate, diagnostic/therapeutic success of DBE.

Methods

An age cutoff of 75 years and older was used to designate patients as elderly. Data on complications, indications, findings, and diagnostic and therapeutic success of DBE were compared between age groups.

Results

The mean age of patients was 66 ± 16.4 years (range 20-95 years). DBE was performed in 185 patients, including 60 patients age 75 years and older and 110 patients younger than age 75. An overall complication rate of 0.9% was seen for DBE in this study, with no significant difference between age groups. No major complications were observed in elderly patients. Elderly patients were more likely to have angioectasias (39% vs 23%; P = .01) and were more likely to require endoscopic therapy during DBE (46.8% vs 29.2%; P = .01).

Limitations

Single-center, retrospective study.

Conclusions

DBE is safe in elderly patients. Elderly patients are more likely to have angioectasias and to require endoscopic therapy during DBE.

Section snippets

Patient population

We retrospectively reviewed data from a prospectively collected database at Fox Chase Cancer Center on all patients undergoing DBE for the evaluation of small-bowel disease between August 2007 and August 2008. Data collection and analysis were approved by our institutional review board. A total of 170 patients and 216 procedures were identified during this period. An age cutoff of 75 years old and older was used to designate patients as elderly. A total of 60 patients were designated as elderly

Patient characteristics

Table 1 shows the demographic data on patients undergoing DBE at our center. The mean age of patients in the elderly group was 83.4 ± 5.3 years compared with 57.2 ± 13.2 years in the age younger than age 75 group (P < .0001).

A high percentage of our patients were white (85%). However, there was no significant difference in the proportion of white patients between both age groups. In the elderly group, there was a significantly higher percentage of patients with cardiac disease (46.7% vs 28.2%; P

Discussion

This is the first published report on the safety, findings, and outcomes of DBE in elderly patients. Age cutoffs of older than 65 and older than 80 years have been used to designate elderly status and advanced age, respectively.²¹ We used a cutoff 75 years and older to denote elderly status in this study, because this was between the above-mentioned age range and has been previously used as a cutoff for elderly status.²² The mean age of patients in the elderly group in this study was 83.4 ± 5.3

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: DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: O. Haluszka: Consultant for EZEM, Boston Scientific, and Fujinon Inc; teaches for Spirus, Inc. J. L. Tokar: Speaker and consultant for Fujinon Inc; consultant for Boston Scientific. The other authors disclosed no financial relationships relevant to this publication.

: Double balloon enteroscopy (DBE) in the elderly: indications, findings, and agreement with video capsule endoscopy and Safety of double balloon enteroscopy in patients >age 75 years: a single center one-year experience.

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Original articleClinical endoscopyDouble-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success

Background

Objective

Design

Setting

Patients

Interventions

Main Outcome Measurements

Methods

Results

Limitations

Conclusions

Section snippets

Patient population

Patient characteristics

Discussion

Gastrointest Endosc

Gastroenterology

Clin Gastroenterol Hepatol

Gastrointest Endosc

Gastrointest Endosc

Clin Gastroenterol Hepatol

Gastrointest Endosc

Gastrointest Endosc

Gastroenterology

Arch Gerontol Geriatr

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Gastrointest Endosc

Clin Gastroenterol Hepatol

Gastrointest Endosc

Original article
Clinical endoscopy
Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success