Factors associated with reduced insertion depth at double balloon enteroscopy: a retrospective, multivariate analysis.

Background: Deep small bowel insertion during double balloon enteroscopy can be difficult to achieve.
Aims: To determine the factors influencing depth of insertion during double balloon enteroscopy.
Methods: History of abdomino-pelvic surgery, route of insertion, type of enteroscope, age, sedation or general anaesthesia used and gender were considered as potential influencing factors; procedures were categorised accordingly and maximal depth of insertion calculated.
Results: At multivariate analysis, maximal depth of insertion was significantly associated with history of abdominal-pelvic surgery (P<0.001), rectal approach (P=0.011), gender (P=0.02) and use of the therapeutic enteroscope (P=0.047). Mean maximal depth of insertion was 266±12cm, 255±9cm (P=0.50), 197±10cm (P<0.0001), 160±12cm (P<0.01) and 103±33cm (P<0.15) when 0, 1, 2, 3 and 4 influencing factors were present, respectively.
Conclusion: Maximal depth of insertion was significantly influenced by history of abdomino-pelvic surgery, insertion route, gender and type of enteroscope used.
(Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)