Endoscopy 2007; 39(7): 613-615
DOI: 10.1055/s-2007-966444
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Complications of double balloon enteroscopy: a multicenter survey

P.  B.  F.  Mensink1 , J.  Haringsma1 , T.  Kucharzik2 , C.  Cellier3 , E.  Pérez-Cuadrado4 , K.  Mönkemüller5 , A.  Gasbarrini6 , A.  J.  Kaffes7 , K.  Nakamura8 , H.  H.  Yen9 , H.  Yamamoto10
  • 1Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
  • 2Department of Medicine B, University of Muenster, Muenster, Germany
  • 3Department of Gastroenterology, Georges Pompidou European Hospital, Paris, France
  • 4Unit of Small Bowel, Section of Digestive Diseases, Hospital General Universitario Morales Meseguer, Murcia, Spain
  • 5Division of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg University Hospital, Magdeburg, Germany
  • 6Department of Internal Medicine and Endoscopy, Gemelli Hospital, Catholic University, Rome, Italy
  • 7Department of Gastroenterology and Hepatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  • 8Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • 9Department of Gastroenterology, Changhua Christian Medical Center, Changhua, Taiwan
  • 10Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi, Japan
Further Information

Publication History

submitted 11 December 2006

accepted after revision 7 February 2007

Publication Date:
21 May 2007 (online)

Background and study aims: Double balloon enteroscopy (DBE) is a new technique for the visualization of the small bowel. Although the technique is widely used, little is known about the complications. A few complications have been reported in the literature, mainly in case reports. The aim of this study was to establish the complication rate of both diagnostic and therapeutic DBE. Patients and methods: A total of 10 centers (nine academic centers and one teaching hospital) across four continents participated in the study. Complications were defined according to the literature. A therapeutic DBE was defined as a DBE with use of argon plasma coagulation, a polypectomy snare, injection of fluids (other than ink for marking), removal of foreign body, or balloon dilation. Results: A total 85 adverse events were reported in 2362 DBE procedures. In all, 40 events fulfilled the definition of a complication, 13 in 1728 diagnostic DBE (0.8 %) and 27 during 634 therapeutic procedures (4.3 %). The complications were rated minor in 21 (0.9 %), moderate in 6 (0.3 %) and severe in 13 procedures (0.6 %). No fatal complications were reported. Seven cases of pancreatitis were reported, six after diagnostic (0.3 %) and one after therapeutic (0.2 %) DBE. Conclusions: Diagnostic DBE is safe with a low complication rate. The complication rate of therapeutic DBE is high compared with therapeutic colonoscopy. The reason for this is unclear. The incidence of pancreatitis after DBE is low (0.3 %), but has to be considered in patients with persistent abdominal complaints after a DBE procedure.


P. B. F. Mensink, MD, PhD

Erasmus MC - University Medical Center
Department of Gastroenterology and Hepatology

Dr. Molewaterplein 40
3015 GD Rotterdam
The Netherlands

Fax: +31-10-4634680

Email: p.mensink@erasmusmc.nl