Gut and Liver (May 2021)

Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study

  • Seong Ran Jeon,
  • Jin-Oh Kim,
  • Jeong-Sik Byeon,
  • Dong-Hoon Yang,
  • Bong Min Ko,
  • Hyeon Jeong Goong,
  • Hyun Joo Jang,
  • Soo Jung Park,
  • Eun Ran Kim,
  • Sung Noh Hong,
  • Jong Pil Im,
  • Seong-Eun Kim,
  • Ja Seol Koo,
  • Chang Soo Eun,
  • Dong Kyung Chang,
  • Korean Association for the Study of Intestinal Diseases (KASID)

DOI
https://doi.org/10.5009/gnl20023
Journal volume & issue
Vol. 15, no. 3
pp. 375 – 382

Abstract

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Background/Aims: Although balloon-assisted enteroscopy (BAE) enables endoscopic visualization of small bowel (SB) involvement in Crohn’s disease (CD), there is no data on the changes in outcomes over time. We therefore investigated the changes in BAE use on CD patients over different time periods in terms of its role and clinical outcomes. Methods: We used a multicenter enteroscopy database to identify CD patients with SB involvement who underwent BAE (131 procedures, 116 patients). We compared BAE-related factors and outcomes between the first period (70 procedures, 60 patients) and the second period (61 procedures, 56 patients). The specific cutoff point for dividing the two periods was 2007, when BAE guidelines were introduced. Results: Initial diagnosis of SB involvement in CD was the most common indication for BAE during each period (50.0% vs 31.1%, p=0.034). The largest change was in the number of BAE uses for stricture evaluation and/or treatment, which increased significantly in the latter period (2.9% vs 21.3%, p=0.002). The diagnostic yield in patients with suspected CD was 90.7% in the first period and 95.0% in the second (p=0.695). More endoscopic interventions were performed in the second period than in the first (5.1% vs 17.6%, p=0.041). Enteroscopic success rates were high throughout (100% in the first period vs 80.0% in the second period, p>0.999). In the first and second periods, therapeutic plans were adjusted in 62.7% and 61.4% of patients, respectively. Conclusions: The overall clinical indications, outcomes, and effectiveness of BAE were constant over time in CD patients with SB involvement, with the exception that the frequency of enteroscopic intervention increased remarkably.

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