Double-balloon enteroscopy evaluation and surveillance in patients with short bowel syndrome

Background: Safety and usefulness of double-balloon enteroscopy (DBE) in patients with short bowel syndrome (SBS) are unknown. DBE could be effective in exploring the residual small bowel (SB) entirely, in monitoring patients receiving teduglutide (TED) treatment and, if necessary, could be operative. Objective: This study aimed to assess the safety, feasibility, and efficacy of enteroscopy in SBS patients. Design: Single center, retrospective. Methods: We collected data on patients with SBS patients undergoing DBE from December 2019 to October 2023. We analyzed the technical success total enteroscopy rates, adverse events, diagnostic yield, and residual SB length measurement. Results: A total of 12 SBS patients (8 females, median age at first enteroscopy, 66 years, interquartile range (IQR) 58-79) were included; among them, 10 received TED therapy (median interval from TED prescription to DBE surveillance 9.1 months (IQR 3.2-32.9)). Overall, 15 DBE procedures (3 retrograde) were performed, all of which were technically successful and completed without adverse events. The overall diagnostic yield was 60% for relevant findings, defined as conditions unknown before DBE. No SB malignancies were detected during the study period. In 80% of cases, a complete visualization of the SB was obtained with a reevaluation of the SB length. The median depth of maximal insertion was 85 cm (IQR 50-187). Conclusion: DBE is feasible, safe, and effective in SBS patients. Total enteroscopy can be frequently achieved with a single approach in these patients, allowing easy diagnostic and oncologic surveillance for SB and colonic malignancy.