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Service Line: Rapid Response Service

Version: 1.0

Publication Date: May 3, 2017

Report Length: 16 Pages

CADTH RAPID RESPONSE REPORT: REFERENCE LIST

Balloon Assisted Enteroscopy for Conditions of the Small Bowel: Clinical Effectiveness

REFERENCE LIST Balloon Assisted Enteroscopy for Conditions of the Small Bowel 2

Authors: Calvin Young, Sarah Jones

Cite As: Balloon assisted enteroscopy for conditions of the small bowel: Clinical effectiveness. Ottawa: CADTH; 2017 May. (CADTH rapid response report:

reference list).

Acknowledgments:

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Research Questions

1. What is the clinical effectiveness of balloon assisted enteroscopy for conditions of the small bowel?

2. What is the cost-effectiveness of balloon assisted enteroscopy for conditions of the small bowel?

3. What are the evidence-based guidelines for use of balloon assisted enteroscopy for conditions of the small bowel?

Key Findings

Two systematic reviews with meta-analyses, one randomized controlled trial, and six non-

randomized studies were identified regarding the clinical effectiveness and benefit of small-

bowel balloon enteroscopy in adults.

Methods

A limited literature search was conducted on key resources including PubMed, The

Cochrane Library, University of York Centre for Reviews and Dissemination (CRD)

databases, Canadian and major international health technology agencies, as well as a

focused Internet search. Methodological filters were applied to limit retrieval to health

technology assessments, systematic reviews, meta-analyses, randomized controlled trials,

non-randomized studies, economic studies, and guidelines. Where possible, retrieval was

limited to the human population. The search was also limited to English language

documents published between January 1, 2012 and April 27, 2017. Internet links were

provided, where available.

Selection Criteria

One reviewer screened citations and selected studies based on the inclusion criteria

presented in Table 1.

Table 1: Selection Criteria

Population Adult patients requiring enteroscopy procedures

Intervention Small-bowel balloon enteroscopy (double- or single-balloon assisted)

Comparator Q1-2: Intraoperative enteroscopy; Double-balloon enteroscopy Single-balloon enteroscopy Q3: No comparator

Outcomes Q1: Clinical effectiveness, clinical benefit or harm, safety Q2: Cost-effectiveness Q3: Guidelines

Study Designs Health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies, economic evaluations, evidence-based guidelines


Results

Rapid Response reports are organized so that the higher quality evidence is presented first.

Therefore, health technology assessment reports, systematic reviews, and meta-analyses

are presented first. These are followed by randomized controlled trials, non-randomized

studies, economic evaluations, and evidence-based guidelines.

Two systematic reviews with meta-analyses, one randomized controlled trial, and six non-

randomized studies were identified regarding the clinical effectiveness and benefit of small-

bowel balloon enteroscopy in adults. No relevant health technology assessments, economic

evaluations, or evidence based guidelines were identified.

Additional references of potential interest are provided in the appendix.

Health Technology Assessments

No literature identified.

Systematic Reviews and Meta-Analyses

1. Lipka S, Rabbanifard R, Kumar A, Brady P. Single versus double balloon enteroscopy

for small bowel diagnostics: a systematic review and meta-analysis. J Clin

Gastroenterol. 2015 Mar;49(3):177-84.

PubMed: PM25564409

2. Wadhwa V, Sethi S, Tewani S, Garg SK, Pleskow DK, Chuttani R, et al. A meta-

analysis on efficacy and safety: single-balloon vs. double-balloon enteroscopy.

Gastroenterol Rep (Oxf). 2015 May;3(2):148-55. Available from:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423464

PubMed: PM25698560

Randomized Controlled Trials

3. Efthymiou M, Desmond PV, Brown G, La Nauze R, Kaffes A, Chua TJ, et al. SINGLE-

01: a randomized, controlled trial comparing the efficacy and depth of insertion of

single- and double-balloon enteroscopy by using a novel method to determine insertion

depth. Gastrointest Endosc. 2012 Nov;76(5):972-80.

PubMed: PM22980289

Non-Randomized Studies

4. Lu Z, Qi Y, Weng J, Ma L, Wan X, Wan R, et al. Efficacy and Safety of Single-Balloon

Versus Double-Balloon Enteroscopy: A Single-Center Retrospective Analysis. Med Sci

Monit. 2017 Apr 22;23:1933-9.

PubMed: PM28432283

5. De Koning M, Moreels TG. Comparison of double-balloon and single-balloon

enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y

small bowel surgery. BMC Gastroenterol [Internet]. 2016 Aug 22 [cited 2017 May

2];16(1):98. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994384

PubMed: PM27549034

http://www.ncbi.nlm.nih.gov/pubmed/25564409http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423464http://www.ncbi.nlm.nih.gov/pubmed/25698560http://www.ncbi.nlm.nih.gov/pubmed/22980289http://www.ncbi.nlm.nih.gov/pubmed/28432283http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994384http://www.ncbi.nlm.nih.gov/pubmed/27549034


6. Lin MC, Chen PJ, Shih YL, Huang HH, Chang WK, Hsieh TY, et al. Outcome and Safety

of Anterograde and Retrograde Single-Balloon Enteroscopy: Clinical Experience at a

Tertiary Medical Center in Taiwan. PLoS ONE [Internet]. 2016 [cited 2017 May

2];11(8):e0161188. Available from:


PubMed: PM27548619

7. Lenz P, Roggel M, Domagk D. Double- vs. single-balloon enteroscopy: single center

experience with emphasis on procedural performance. Int J Colorectal Dis. 2013

Sep;28(9):1239-46.

PubMed: PM23503664

8. Sanaka MR, Navaneethan U, Kosuru B, Yerneni H, Lopez R, Vargo JJ. Antegrade is

more effective than retrograde enteroscopy for evaluation and management of

suspected small-bowel disease. Clin Gastroenterol Hepatol. 2012 Aug;10(8):910-6.

PubMed: PM22610006

9. Sidhu R, McAlindon ME, Drew K, Hardcastle S, Cameron IC, Sanders DS. Evaluating

the role of small-bowel endoscopy in clinical practice: the largest single-centre

experience. Eur J Gastroenterol Hepatol. 2012 May;24(5):513-9.

PubMed: PM22330235

Economic Evaluations


Guidelines and Recommendations


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993377http://www.ncbi.nlm.nih.gov/pubmed/27548619http://www.ncbi.nlm.nih.gov/pubmed/23503664http://www.ncbi.nlm.nih.gov/pubmed/22610006http://www.ncbi.nlm.nih.gov/pubmed/22330235


Appendix — Further Information

Systematic Reviews and Meta-Analyses

No/Alternate Comparator

10. Elli L, Casazza G, Locatelli M, Branchi F, Ferretti F, Conte D, et al. Use of enteroscopy

for the detection of malignant and pre-malignant lesions of the small bowel in

complicated celiac disease: a meta-analysis. Gastrointest Endosc. 2017 Apr 19.

PubMed: PM28433612

11. Arulanandan A, Dulai PS, Singh S, Sandborn WJ, Kalmaz D. Systematic review: Safety

of balloon assisted enteroscopy in Crohn's disease. World J Gastroenterol.[Internet]

2016 Oct 28 [cited 2017 May 2];22(40):8999-9011. Available from:


PubMed: PM27833391

12. Inamdar S, Slattery E, Sejpal DV, Miller LS, Pleskow DK, Berzin TM, et al. Systematic

review and meta-analysis of single-balloon enteroscopy-assisted ERCP in patients with

surgically altered GI anatomy. Gastrointest Endosc. 2015 Jul;82(1):9-19.

PubMed: PM25922248

Randomized Controlled Trials

Alternate Comparator

13. Li X, Zhao YJ, Dai J, Li XB, Xue HB, Zhang Y, et al. Carbon dioxide insufflation

improves the intubation depth and total enteroscopy rate in single-balloon enteroscopy:

a randomised, controlled, double-blind trial. Gut. 2014 Oct;63(10):1560-5.

PubMed: PM24626435

14. Messer I, May A, Manner H, Ell C. Prospective, randomized, single-center trial

comparing double-balloon enteroscopy and spiral enteroscopy in patients with

suspected small-bowel disorders. Gastrointest Endosc. 2013 Feb;77(2):241-9.

PubMed: PM23043851

Non-Randomized Studies

No/Alternate Comparator

15. Goverde A, Korsse SE, Wagner A, van Leerdam ME, Krak NC, Stoker J, et al. Small-

bowel Surveillance in Patients With Peutz-Jeghers Syndrome: Comparing Magnetic

Resonance Enteroclysis and Double Balloon Enteroscopy. J Clin Gastroenterol. 2017

Apr;51(4):e27-e33.

PubMed: PM27404294

16. Hermans C, Stronkhorst A, Tjhie-Wensing A, Kamphuis J, Balkom BV, Dahlmans R, et

al. Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results,

Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral

Center. Clin Endosc [Internet]. 2017 Jan [cited 2017 May 2];50(1):69-75. Available from:


PubMed: PM28076941

http://www.ncbi.nlm.nih.gov/pubmed/28433612http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083805http://www.ncbi.nlm.nih.gov/pubmed/27833391http://www.ncbi.nlm.nih.gov/pubmed/25922248http://www.ncbi.nlm.nih.gov/pubmed/24626435http://www.ncbi.nlm.nih.gov/pubmed/23043851http://www.ncbi.nlm.nih.gov/pubmed/27404294http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299980http://www.ncbi.nlm.nih.gov/pubmed/28076941


17. Marques M, Antunes J, Coelho R, Cardoso H, Vilas BF, Ribeiro A, et al. Single-balloon

enteroscopy efficacy and degree of concordance with noninvasive evaluation of small

bowel. Endosc Int Open [Internet]. 2017 Feb [cited 2017 May 2];5(2):E96-E102.

Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5305424

PubMed: PM28210706

18. Nakamura M, Hirooka Y, Watanabe O, Yamamura T, Funasaka K, Ohno E, et al. A

Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon

Endoscopy in Crohn's Disease. Gastroenterol Res Pract [Internet]. 2016 [cited 2017

May 2];2016:1085027. Available from:


PubMed: PM26843856

19. Shiani A, Nieves J, Lipka S, Patel B, Kumar A, Brady P. Degree of concordance

between single balloon enteroscopy and capsule endoscopy for obscure gastrointestinal

bleeding after an initial positive capsule endoscopy finding. Therap Adv Gastroenterol.

[Internet] 2016 Jan [cited 2017 May 2];9(1):13-8. Available from:


PubMed: PM26770263

20. Despott EJ, Murino A, Bourikas L, Nakamura M, Ramachandra V, Fraser C. A

prospective comparison of performance during back-to-back, anterograde manual spiral

enteroscopy and double-balloon enteroscopy. Dig Liver Dis. 2015 May;47(5):395-400.

PubMed: PM25869553

21. Goyal J, Kim H, Khan AS, Monkemuller K, Peter S. Predictability of capsule endoscopy

referred to a tertiary care center for double-balloon enteroscopy. Eur J Gastroenterol

Hepatol. 2015 Sep;27(9):1052-6.

PubMed: PM26049708

22. Holleran G, Hall B, Alhinai M, Zaheer A, Leen R, Alakkari A, et al. Double-balloon

enteroscopy in Ireland in the capsule endoscopy era. Ir J Med Sci. 2015

Mar;184(1):257-62.

PubMed: PM24633527

23. Kalra AS, Walker AJ, Benson ME, Soni A, Guda NM, Misha M, et al. Comparison of

capsule endoscopy findings to subsequent double balloon enteroscopy: A dual center

experience. Diagn Ther Endosc. [Internet] 2015 [cited 2017 May 2];2015:438757.


PubMed: PM26420979

24. Zhang ZH, Qiu CH, Li Y. Different roles of capsule endoscopy and double-balloon

enteroscopy in obscure small intestinal diseases. World J Gastroenterol. [Internet] 2015

Jun 21 [cited 2017 May 2];21(23):7297-304. Available from:


PubMed: PM26109818

25. Takenaka K, Ohtsuka K, Kitazume Y, Nagahori M, Fujii T, Saito E, et al. Comparison of

magnetic resonance and balloon enteroscopic examination of the small intestine in

patients with Crohn's disease. Gastroenterology. 2014 Aug;147(2):334-42.

PubMed: PM24732015

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5305424http://www.ncbi.nlm.nih.gov/pubmed/28210706http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710939http://www.ncbi.nlm.nih.gov/pubmed/26843856http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699275http://www.ncbi.nlm.nih.gov/pubmed/26770263http://www.ncbi.nlm.nih.gov/pubmed/25869553http://www.ncbi.nlm.nih.gov/pubmed/26049708http://www.ncbi.nlm.nih.gov/pubmed/24633527http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569779http://www.ncbi.nlm.nih.gov/pubmed/26420979http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476893http://www.ncbi.nlm.nih.gov/pubmed/26109818http://www.ncbi.nlm.nih.gov/pubmed/24732015


26. Tomba C, Elli L, Bardella MT, Soncini M, Contiero P, Roncoroni L, et al. Enteroscopy for

the early detection of small bowel tumours in at-risk celiac patients. Dig Liver Dis. 2014

May;46(5):400-4.

PubMed: PM24440311

27. Tsai CJ, Sanaka MR, Menon KV, Vargo JJ. Balloon-assisted enteroscopy in portal

hypertensive enteropathy. Hepatogastroenterology. 2014 Sep;61(134):1635-41.

PubMed: PM25436355

28. He Q, Zhang YL, Xiao B, Jiang B, Bai Y, Zhi FC. Double-balloon enteroscopy for

diagnosis of Meckel's diverticulum: comparison with operative findings and capsule

endoscopy. Surgery. 2013 Apr;153(4):549-54.

PubMed: PM23305600

29. Rahmi G, Samaha E, Vahedi K, Ponchon T, Fumex F, Filoche B, et al. Multicenter

comparison of double-balloon enteroscopy and spiral enteroscopy. J Gastroenterol

Hepatol. 2013 Jun;28(6):992-8.

PubMed: PM23488827

30. Honda W, Ohmiya N, Hirooka Y, Nakamura M, Miyahara R, Ohno E, et al. Enteroscopic

and radiologic diagnoses, treatment, and prognoses of small-bowel tumors. Gastrointest

Endosc. 2012 Aug;76(2):344-54.

PubMed: PM22817787

31. Lennon AM, Kapoor S, Khashab M, Corless E, Amateau S, Dunbar K, et al. Spiral

assisted ERCP is equivalent to single balloon assisted ERCP in patients with Roux-en-

Y anatomy. Dig Dis Sci. 2012 May;57(5):1391-8.

PubMed: PM22198702

32. Nakatani M, Fujiwara Y, Nagami Y, Sugimori S, Kameda N, Machida H, et al. The

usefulness of double-balloon enteroscopy in gastrointestinal stromal tumors of the small

bowel with obscure gastrointestinal bleeding. Intern Med. 2012;51(19):2675-82.

PubMed: PM23037455

33. Schreiner MA, Chang L, Gluck M, Irani S, Gan SI, Brandabur JJ, Thirlby R, Moonka R,

Kozarek RA, Ross AS. Laparoscopy-assisted versus balloon enteroscopy-assisted

ERCP in bariatric post-Roux-en-Y gastric bypass patients. Gastrointestinal Endoscopy

[Internet] 2012 [cited 2017 May 2]; 75(4): 748-756. Available from:

http://www.giejournal.org/article/S0016-5107(11)02429-1/abstract

34. Shishido T, Oka S, Tanaka S, Aoyama T, Watari I, Imagawa H, et al. Diagnostic yield of

capsule endoscopy vs. double-balloon endoscopy for patients who have undergone

total enteroscopy with obscure gastrointestinal bleeding. Hepatogastroenterology. 2012

Jun;59(116):955-9.

PubMed: PM22580642

35. Wiarda BM, Mensink PB, Heine DG, Stolk M, Dees J, Hazenberg H, et al. Small bowel

Crohn's disease: MR enteroclysis and capsule endoscopy compared to balloon-assisted

enteroscopy. Abdom Imaging [Internet]. 2012 Jun [cited 2017 May 2];37(3):397-403.


PubMed: PM22120660

http://www.ncbi.nlm.nih.gov/pubmed/24440311http://www.ncbi.nlm.nih.gov/pubmed/25436355http://www.ncbi.nlm.nih.gov/pubmed/23305600http://www.ncbi.nlm.nih.gov/pubmed/23488827http://www.ncbi.nlm.nih.gov/pubmed/22817787http://www.ncbi.nlm.nih.gov/pubmed/22198702http://www.ncbi.nlm.nih.gov/pubmed/23037455http://www.giejournal.org/article/S0016-5107(11)02429-1/abstracthttp://www.ncbi.nlm.nih.gov/pubmed/22580642http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345178http://www.ncbi.nlm.nih.gov/pubmed/22120660


Pediatric/Mixed Population

36. Belsha D, Urs A, Attard T, Thomson M. Effectiveness of double-balloon enteroscopy-

facilitated polypectomy in paediatric patients With PEUTZ-Jeghers Syndrome. J Pediatr

Gastroenterol Nutr. 2017 Mar 17.

PubMed: PM28319601

37. Bizzarri B, Borrelli O, de'Angelis N, Ghiselli A, Nervi G, Manfredi M, et al. Management

of duodenal-jejunal polyps in children with peutz-jeghers syndrome with single-balloon

enteroscopy. J Pediatr Gastroenterol Nutr. 2014 Jul;59(1):49-53.

PubMed: PM24590213

38. Urs AN, Martinelli M, Rao P, Thomson MA. Diagnostic and therapeutic utility of double-

balloon enteroscopy in children. J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):204-12.

PubMed: PM24126830

39. Zheng CF, Huang Y, Tang ZF, Chen L, Leung YK. Double-balloon enteroscopy for the

diagnosis of Meckel's diverticulum in pediatric patients with obscure GI bleeding.

Gastrointest Endosc. 2014 Feb;79(2):354-8.

PubMed: PM24016356

40. Gurkan OE, Karakan T, Dogan I, Dalgic B, Unal S. Comparison of double balloon

enteroscopy in adults and children. World J Gastroenterol.[Internet] 2013 Aug 7 [cited

2017 May 2];19(29):4726-31. Available from:


PubMed: PM23922469

41. Ono S, Maeda K, Baba K, Usui Y, Tsuji Y, Yano T, et al. The efficacy of double-balloon

enteroscopy for intrahepatic bile duct stones after Roux-en-Y hepaticojejunostomy for

choledochal cysts. Pediatr Surg Int. 2013 Nov;29(11):1103-7.

PubMed: PM23979399

42. de Ridder L, Mensink PB, Lequin MH, Aktas H, de Krijger RR, van der Woude CJ, et al.

Single-balloon enteroscopy, magnetic resonance enterography, and abdominal US

useful for evaluation of small-bowel disease in children with (suspected) Crohn's

disease. Gastrointest Endosc. 2012 Jan;75(1):87-94.

PubMed: PM21963066

43. Di Nardo G, Oliva S, Aloi M, Rossi P, Casciani E, Masselli G, et al. Usefulness of single-

balloon enteroscopy in pediatric Crohn's disease. Gastrointest Endosc. 2012

Jan;75(1):80-6.

PubMed: PM21855873

44. Shen R, Sun B, Gong B, Zhang S, Cheng S. Double-balloon enteroscopy in the

evaluation of small bowel disorders in pediatric patients. Dig Endosc. 2012

Mar;24(2):87-92.

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45. Uchida K, Yoshiyama S, Inoue M, Koike Y, Yasuda H, Fujikawa H, et al. Double balloon

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9.

PubMed: PM22564182

http://www.ncbi.nlm.nih.gov/pubmed/28319601http://www.ncbi.nlm.nih.gov/pubmed/24590213http://www.ncbi.nlm.nih.gov/pubmed/24126830http://www.ncbi.nlm.nih.gov/pubmed/24016356http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732844http://www.ncbi.nlm.nih.gov/pubmed/23922469http://www.ncbi.nlm.nih.gov/pubmed/23979399http://www.ncbi.nlm.nih.gov/pubmed/21963066http://www.ncbi.nlm.nih.gov/pubmed/21855873http://www.ncbi.nlm.nih.gov/pubmed/22348832http://www.ncbi.nlm.nih.gov/pubmed/22564182


No Comparator

46. Koul A, Pham DM, Nanda A, Woods KE, Keilin SD. Safety and efficacy of single-balloon

enteroscopy in management of gastrointestinal bleeding in patients with a left

ventricular assist device. Endosc Int Open. [Internet] 2017 Mar [cited 2017 May

2];5(3):E179-E183. Available from:


PubMed: PM28299353

47. Albrecht H, Hagel WH, Hagel AF, Neurath MF, Raithel M. Double-balloon enteroscopy-

detected lipid islets in the small bowel are strong predictors of cardiovascular disease

when associated with angiectasia and bleeding. J Gastrointestin Liver Dis. 2016

Mar;25(1):33-7.

PubMed: PM27014769

48. Cai JX, Diehl DL, Kiesslich R, Storm AC, El Zein MH, Tieu AH, et al. A multicenter

experience of through-the-scope balloon-assisted enteroscopy in surgically altered

gastrointestinal anatomy. Surg Endosc. 2016 Dec 30.

PubMed: PM28039647

49. Chen WG, Shan GD, Zhang H, Yang M, L L, Yue M, et al. Double-balloon enteroscopy

in small bowel diseases: Eight years single-center experience in China. Medicine

(Baltimore). 2016 Oct;95(42):e5104. Available from:


PubMed: PM27759639

50. Christian KE, Kapoor K, Goldberg EM. Performance characteristics of retrograde single-

balloon endoscopy: A single center experience. World J Gastrointest Endosc. [Internet]

2016 Aug 10 [cited 2017 May 2];8(15):501-7. Available from:


PubMed: PM27606042

51. Kroner PT, Brahmbhatt BS, Bartel MJ, Stark ME, Lukens FJ. Yield of double-balloon

enteroscopy in the diagnosis and treatment of small bowel strictures. Dig Liver Dis.

2016 Apr;48(4):446-8.

PubMed: PM26725164

52. Mitsui K, Fujimori S, Tanaka S, Ehara A, Omori J, Akimoto N, et al. Retrieval of retained

capsule endoscopy at small bowel stricture by double-balloon endoscopy significantly

decreases surgical treatment. J Clin Gastroenterol. 2016 Feb;50(2):141-6.

PubMed: PM25930974

53. Murino A, Nakamura M, Watanabe O, Yamamura T, Nagura A, Yoshimura T, et al.

Effectiveness of endoscopic ultrasonography during double balloon enteroscopy for

characterization and management of small bowel submucosal tumours. Dig Liver Dis.

2016 Oct;48(10):1187-93.

PubMed: PM27474200

54. Sunada K, Shinozaki S, Nagayama M, Yano T, Takezawa T, Ino Y, et al. Long-term

outcomes in patients with small intestinal strictures secondary to Crohn's disease after

double-balloon endoscopy-assisted balloon dilation. Inflamm Bowel Dis. 2016

Feb;22(2):380-6.

PubMed: PM26535767

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348294http://www.ncbi.nlm.nih.gov/pubmed/28299353http://www.ncbi.nlm.nih.gov/pubmed/27014769http://www.ncbi.nlm.nih.gov/pubmed/28039647http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079323http://www.ncbi.nlm.nih.gov/pubmed/27759639http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980639http://www.ncbi.nlm.nih.gov/pubmed/27606042http://www.ncbi.nlm.nih.gov/pubmed/26725164http://www.ncbi.nlm.nih.gov/pubmed/25930974http://www.ncbi.nlm.nih.gov/pubmed/27474200http://www.ncbi.nlm.nih.gov/pubmed/26535767


55. Tomba C, Sidhu R, Sanders DS, Mooney PD, Branchi F, Locatelli M, et al. Celiac

disease and double-balloon enteroscopy: What can we achieve?: The experience of 2

European tertiary referral centers. J Clin Gastroenterol. 2016 Apr;50(4):313-7.

PubMed: PM26524152

56. Tsou YK, Lee MS, Chen KF, Lin CH, Sung KF, Wu CC. Double-balloon enteroscopy-

assisted endoscopic retrograde cholangiography for Roux-en-Y reconstruction patients

with papilla of Vater or bilioenteric anastomosis. Scand J Gastroenterol. 2016

Jan;51(1):95-102.

PubMed: PM26067876

57. Davis-Yadley AH, Lipka S, Rodriguez AC, Nelson KK, Doraiswamy V, Rabbanifard R, et

al. The safety and efficacy of single balloon enteroscopy in the elderly. Therap Adv

Gastroenterol. [Internet] 2016 Mar [cited 2017 May 2];9(2):169-79. Available from:


PubMed: PM26929779

58. Cangemi DJ, Stark ME, Cangemi JR, Lukens FJ, Gomez V. Double-balloon

enteroscopy and outcomes in patients older than 80. Age Ageing. 2015 May;44(3):529-

32.

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