526 The Efficacy and Safety of Device-Assisted Enteroscopy and Push Enteroscopy in Cirrhosis Patients

Abstract

INTRODUCTION: Small bowel Push enteroscopy (PE) and device-assisted enteroscopy (DAE); including double balloon, single balloon or spiral enteroscopy are modalities that used in evaluating and treating obscure gastrointestinal bleeding and small bowel lesions. Limited data are available on the safety and efficacy of these procedures in the cirrhotic population. The aim of this study is to assess the efficacy and the safety of DAE and PE in cirrhotic patients. METHODS: A retrospective chart review of cirrhotic patients from a single center between January 2006 and January 2016 who had device-assisted enteroscopy or PE procedure. Success rate, duration of the procedure, anesthesia time, and procedure complications were collected. Patients' age, sex, MELD score, child-Pugh score (CTP) were also reviewed and analyzed. RESULTS: A total of 42 procedures, including 22 PE and 20 DAE, in 33 cirrhotic patients were reviewed. The mean age was 59.3 years (range: 29-86 years). The most common findings were angioectasias followed by ulcers and inflammatory changes. A longer duration time was associated with the device-assisted enteroscopy when compared to the PE group, the mean time was 58 minutes and 37 minutes respectively (P-value of 0.03). The anesthesia time was longer in the DAE with an average of 83 minutes while in the PE , it was 53 minutes (P-value of 0.03). No difference in the time of the procedure was found between the compensated cirrhosis when compared to the decompensated cirrhosis. The device-assisted enteroscopy success rate was 90% versus 100% in PE. No adverse events were seen in both groups. More therapeutic interventions were performed in DAE compared to PE especially bleeding cauterizations and biopsy of lesions while more diagnostic procedures were performed in the PE (Table 1). CONCLUSION: Device-assisted enteroscopy and push enteroscopy are safe procedures in cirrhotic patients with a high success rate. Decompensated cirrhosis does not carry an increased risk of a longer procedure time or complication when compared to the compensated cirrhosis.