Factors That Influence the Speed and Completion of Double Balloon Enteroscopy in Patients with Arteriovenous Malformations

• Published in: Digestive diseases and sciences Vol. 68; no. 1; pp. 173 - 180
• Main Authors: Saunders, Hollie, Ghoz, Hassan, Cortes, Pedro, Alsafi, Wail, Mzaik, Obaie, Ciofoaia, Victor, Kroner, Paul, Rodriguez, Andrea, Kesler, Alex, Koralewski, Andrea, Crawford, Matthew, Lukens, Frank, Stark, Mark, Brahmbhatt, Bhaumik, Stancampiano, Fernando
• Format: Journal Article
• Language: English
• Published: New York Springer US 2023; Springer; Springer Nature B.V
• Subjects: Abdominal surgery; Arteriovenous Malformations - diagnostic imaging; Arteriovenous Malformations - surgery; Biochemistry; Double-Balloon Enteroscopy - methods; Endoscopy; Female; Gastroenterology; Hepatology; Humans; Intestinal Diseases - therapy; Intestine, Small; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Retrospective Studies; Transplant Surgery; Arteriovenous malformations; Speed; Management; Enteroscopy
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-022-07528-2

Background
Double balloon enteroscopy remains a resource and time-intensive procedure that is not available in many endoscopy units.
Aims
We aimed to identify variables impacting the speed and completion of double balloon enteroscopy.
Methods
We retrospectively reviewed 550 patients. Using a mean time and distance for both the antegrade and retrograde approach, we determined the procedure speed and assessed factors that influenced it. In addition, we assessed the factors that contributed to a complete double balloon enteroscopy.
Results
A total of 386 antegrade and 164 retrograde double balloon enteroscopies were performed. Greater than 10 AVMs requiring treatment was a negative predictor (AOR 0.25, CI 0.11–0.51,
p
 < 0.001), whereas age greater than 60 years (AOR 2.66, CI 1.18–6.65,
p
 = 0.025) was a positive predictor of a fast antegrade enteroscopy. For retrograde, prior abdominal surgery was the only factor that trended to significance (AOR 0.38, CI 0.14–0.99,
p
 = 0.052). A total of 120 combined procedures were performed. Female gender (AOR 2.62, CI 1.16–6.24,
p
 = 0.02), history of prior abdominal surgery (AOR 0.31, CI 0.13–0.70,
p
 = 0.006) and Boston bowel pre-preparation score of greater than 6 (AOR 4.50, CI 1.59–14.30,
p
 = 0.006) were the only significant predictors of a complete procedure.
Conclusion
By applying double balloon enteroscopy speed, a novel method of measuring procedure efficiency, we were able to more reliably identify the factors that will negatively impact the speed and success of the procedure.