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Double balloon enteroscopy can be safely done in elderly patients with significant co-morbidities.
MedLine Citation:
PMID:  23034065     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Performance of double balloon enteroscopy (DBE) on older patients with comorbidities is a matter of safety. We aimed to investigate the utility and safety of DBE in older patients. METHODS: We retrospectively reviewed the medical records of patients 75 years or older who underwent DBE in our open-access endoscopy unit in a tertiary center. We analyzed the diagnostic yield, therapeutic intervention, and safety including complications of DBE. RESULTS: Four scheduled DBEs were canceled because of poor conditions. Two hundred fourteen DBEs were performed in 167 elderly patients. All DBEs were performed under monitored anesthesia care using intravenous propofol administered by anesthesiologists. One half of the patients were male (female:male=80:87). The mean age of patients was 80.1±3.7 years. Co-morbidity of significant chronic diseases was noted in 208 (97.2%) DBEs. Fifty one (23.8%) DBEs were performed in patients with American Society of Anesthesiologists (ASA) physical status II, 151 (70.6%) DBEs with ASA class III, and 12 (5.6%) DBEs with ASA class IV. The most common indication was obscure gastrointestinal bleeding. The mean DBE procedure time was 131±51 min. Abnormalities were detected in 129 (60.3%) DBEs with therapeutic interventions performed in 83 (38.8%) cases. Pancreatitis, hypoxia, and aspiration pneumonia developed after 3 (1.4%), 3 (1.4%), and 2 (0.9%) DBEs, respectively, all of which resolved with conservative care. CONCLUSIONS: DBE can be done with acceptable safety in the elderly with high ASA class. DBE shows a high diagnostic yield and can deliver many therapeutic applications.
Authors:
Jeong-Sik Byeon; Neel K Mann; Laith H Jamil; Simon K Lo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
Affiliation:
Cedars-Sinai Medical Center (CSMC), David Geffen School of Medicine at UCLA, Los Angeles, USA; Asan Medical Center, University of Ulan College of Medicine, Seoul, Korea.
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