Mo1964 Efficacy and Safety of Endoscopic Studies in 207 Pediatric and Young Adult Patients: A Japanese Single Children's Hospital Experience

Abstract

Background: The life expectancy of the population is rising. The number of octogenarian (80 years or older) undergoing endoscopy evaluation is rising. The utility of double balloon enteroscopy (DBE) procedure in Octogenarians have not been previously reported. Aim: To determine the safety and diagnostic yield of DBE procedure in the octogenarians. Methods: We reviewed our large prospectively collected DBE database from 2006 to 2011. The octogenarian patients aged 80 years or older were included in our study analysis. Patients' demographics along with DBE procedure indication, findings, and complications were recorded. The safety and diagnostic yield of DBE procedure was calculated by the frequency statistics. Results: A total of 1218 DBE procedure were performed from 2006 to 2011 at our tertiary referral center. Out of these DBE procedures, 108 DBE (60 antegrade and 48 retrograde approaches) performed in 86 different patient encounters among 68 octogenarian (54.4% Male) were included in our study analysis. The average age of these patients was 84 (80-95) years and BMI was 26.2 (18.6-45.13) kg/m2. The most common indication for DBE was overt bleeding 29.6% (See table below). The most common finding during these DBE was bleeding AVM (arterio-venous malformation) among 38% (n=33) encounters. The overall diagnostic (pertinent positive findings) or therapeutic yield of DBE was found to be 91.86% (79/86 encounters). The diagnostic and therapeutic yield was found to be 91% (71/ 78 encounters) for evaluation of gastrointestinal bleeding and 100% (5/5 encounters) for evaluation of suspected mass or bowel stricture among octogenarian. There was no immediate (<48 hours) complications occurred in any of these patients. In 55.8% (n=48) of the total 86 encounters, the patients received capsule endoscopy procedure. Among them, capsule endoscopy found specific lesions in 58.3% (n=28) encounters, nonspecific findings in 35.4% (n=17) encounters and negative in only 6.3% (n=3) encounters. Conclusion: The diagnostic (pertinent positive findings) and therapeutic yield of DBE procedure was found to be more than 90% in the octogenarian patients. The DBE procedure in octogenarians was found to be safe without any complications. Indications and findings of DBE in Octogenarians (total n = 86 encounters)