The Value Of Capsule Endoscopy And Double Balloon Enteroscopy In The Diagnosis Of Small Bowel Diseases

Objective:To explore the value of capsule endoscopy(CE)and double balloon enteroscopy(DBE)in the diagnosis of small bowel diseases.Methods:The clinical and endoscopic data of 403 cases of CE and(or)267 cases of DBE examined in the Second Hospital of Hebei Medical University from January 1,2015 to September 1,2019 were analyzed retrospectively.To evaluate the diagnostic value of domestic CE and imported CE and compare the value of CE and DBE in the diagnosis of small bowel diseases.Results:1.The diagnostic rate of imported CE was better than that of domestic CE(P < 0.01),There was no statistical difference in the success rate,positive detection rate and the completion rate of the whole small intestine examination between the two groups(P > 0.05);The positive detection rate,etiology diagnosis rate and vascular disease detection rate of imported CE in patients with abdominal pain,abdominal distention and abdominal discomfort were better than those of domestic CE(P < 0.05,P < 0.01),but there was no statistical difference in the detection rate of different types of lesions between the two groups(P > 0.05).2.The success rate of CE and DBE in small intestine diseases was 95.3% and 100%,the positive rate was 67.0% and 70.0%,the diagnosis rate of etiology was 46.9% and 55.1%,the complete rate of whole intestine examination was 88.6% and 46.1% respectively,among which DBE was better than CE(P < 0.05),The complete rate of whole small intestine examination of the CE was better than that of DBE(P < 0.01).There was no significant difference in the positive detection rate between the two groups(P> 0.05).3.For different examination indications,there was no statistical difference in the positive detection rate of CE and DBE(P > 0.05),but DBE was superior to CE in the etiological diagnosis rate of abdominal pain,distention and discomfort(P < 0.05).Besides intestinal obstruction,CE had a higher complete rate of whole intestine examination than DBE(P < 0.05);For different types of lesions,CE had a higher detection rate of inflammatory lesions,lymphangiodilation and other lesions(P < 0.01),while DBE had a higher detection rate of ulcerative lesions and diverticulum(P < 0.01).There was no statistical difference between the detection rates of vascular lesions and space occupying lesions(P > 0.05).4.Among CE sequential DBE inspectors,The positive rate of CE and DBE were 92.2% and 74.5% respectively,and CE was higher than DBE(P < 0.05),while the diagnostic rate of etiology was 41.2% and 84.3% respectively,DBE was significantly better than CE(P < 0.01).The positive rate of CE by DBE was 51.1%(24/47),The concordance rate of CE and DBE was 49.0%(25/51),DBE could correct the CE false positive detection result of 25.5%(12/47).DBE had more advantages in the diagnosis of small intestinal tumor and diverticulum.5.There was no significant difference in the positive detection rate of DBE simple oral,simple anal,oral combined anal(stoma)(P > 0.05).There was no significant difference in the positive detection rate and etiological diagnosis rate between oral and transanal(P > 0.05).At the same time,there was no statistical difference in the positive detection rate of three different ways of endoscopy in the diagnosis of small intestinal hemorrhage(P > 0.05).The etiological diagnosis rate of simple oral route was higher than that of simple anal route and combined anal route(P < 0.05,P < 0.01).There was no statistical difference in the positive detection rate and etiological diagnosis rate between the first choice of oral route and the first choice of anal route(P > 0.05).6.The diagnosis rate of DBE was better than that of CE and abdominal CT(P < 0.05).Conclusions:1.Domestic capsule endoscopy can be the first choice for small intestinal diseases.Imported capsule endoscopy is recommended for abdominal pain,abdominal distention,abdominal discomfort and suspected vascular diseases.2.Capsule endoscopy and double balloon enteroscopy have the same value in the detection of small intestinal lesions,among which capsule endoscopy has a high detection rate for inflammatory lesions,lymphangiodilation and other lesions,double balloon enteroscopy has a high detection rate for ulcerative lesions and diverticulum.3.Double balloon enteroscopy is superior to capsule endoscopy in the diagnosis of small bowel diseases,especially small bowel tumors,and is the first choice for clear cause of small bowel diseases,especially abdominal pain,bloating,and abdominal discomfort.4.Double balloon enteroscopy is recommended to choose different entry methods according to the lesion,but when the lesion is uncertain,especially for patients with suspected bleeding,oral entry is the first choice.