The use of double-balloon enteroscopy in retrieving mucosal biopsies from the entire human gastrointestinal tract

• Published in: Scandinavian journal of gastroenterology 2014-09, Vol.49 (9), p.1143-1149
• Main Authors: Rhee, Nicolai Alexander, Vilmann, Peter, Hassan, Hazem, Hendel, Jakob Westergren, Holst, Jens Juul, Vilsbøll, Tina, Knop, Filip Krag
• Format: Article
• Language: English
• Subjects: biopsy; Biopsy - methods; Case-Control Studies; Diabetes Mellitus, Type 2 - pathology; Double-Balloon Enteroscopy; Female; gastrointestinal tract; Humans; Hypnotics and Sedatives - administration & dosage; Intestinal Mucosa - pathology; Intestine, Large - pathology; Intestine, Small - pathology; Male; methodological study; Middle Aged; Propofol - administration & dosage; type 2 diabetes mellitus
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365521.2014.934912

AbstractObjective. The aim of this explorative study was to evaluate double-balloon enteroscopy (DBE) as a new tool for collecting mucosal biopsies from well-defined parts of the entire small and large bowel in patients with type 2 diabetes and in matched healthy subjects. Material and methods. Twelve subjects with type 2 diabetes and 12 body mass index and age-matched healthy subjects underwent anterograde and retrograde DBE under nurse-administered propofol sedation on two separate days. We attempted to collect two mucosal biopsies from every 30 cm from pylorus to rectum. Results. A mean of 21 biopsy sites were sampled in the diabetic group versus 25 in the healthy group. In 4 out of 24 patients (2 [17%] from each group) sampling from the entire gastrointestinal system was possible. Mean depth of maximal insertion (anterograde) was 478 ± 32 cm in patients with type 2 diabetes versus 465 ± 44 cm in healthy subjects (p = 0.81) and with retrograde access 230 ± 36 cm (type 2 diabetes) versus 207 ± 26 cm (healthy subjects). Conclusions. DBE is a minimally invasive way of collecting fresh biopsies from the entire gastrointestinal tract and, thus provides research and clinical communities with a new possibility to access hitherto unexplored human anatomy and physiology.