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Background: Balloon-assisted enteroscopy (BAE) (both single- and double-balloon enteroscopy) has garnered attention in the treatment of small intestine strictures in patients with Crohn's disease (CD). This study aimed to evaluate the pooled clinical outcomes of BAE-mediated endoscopic dilation of small intestine strictures in patients with CD., Methods: We searched multiple databases for articles reporting outcomes following BAE for small intestinal strictures in patients with CD. Outcomes studied were pooled technical success, clinical success and adverse events. Standard meta-analysis methods were employed using the random-effects model, and heterogeneity was studied using I 2 statistics., Results: We analyzed 26 studies, 9 prospective and 17 retrospective, involving 1570 patients. The pooled technical success rate of double-balloon enteroscopy was 87.6% (95% confidence interval [CI] 82.1-91.5; I 2 =53%) and the pooled therapeutic success rate was 69.7% (95%CI 61.6-76.7; I 2 =71%). The pooled major complications per procedure were 5.5% (95%CI 3.5-8.4; I 2 =57%); the risk of bleeding was 2.5% (95%CI 1.4-4.2; I 2 =28%), and the risk of perforation was 2.7% (95%CI 1.6-4.5; I 2 =3%). The pooled rate of recurrence after the first dilation was 42.3% (95%CI 16.9-72.5; I 2 =59%), and the rate of repeat endoscopic balloon dilation was 23.9% (95%CI 14.1%-37.5%; I 2 =85%), while the pooled rate of repeat surgery was 25.3% (95%CI 11.8%-46.0%; I 2 =44%]., Conclusion: BAE is a good first line approach for patients with CD-induced strictures in an attempt to treat symptoms and potentially avoid surgery., Competing Interests: Conflict of Interest: DGA: Consultant for Boston Scientific; all other authors declare no conflicts of interest., (Copyright: © 2024 Hellenic Society of Gastroenterology.)

Background: Left ventricular assist devices (LVADs) are indicated for patients with end-stage heart failure and require systemic anticoagulation. Gastrointestinal (GI) bleeding is a major adverse event following LVAD implantation. There is paucity of data on healthcare resource utilization in patients with LVAD and the risk factors of associated bleeding, despite the increase in GI bleeding. We investigated the in-hospital outcomes of GI bleeding in patients with continuous-flow (CF) LVAD., Methods: This was a serial cross-sectional study of the Nationwide Inpatient Sample (NIS) in the CF-LVAD era from 2008-2017. All adults admitted to hospital with a primary diagnosis of GI bleeding were included. GI bleeding was diagnosed by ICD-9/ICD-10 codes. Patients with CF-LVAD (cases) and without CF-LVAD (controls) were compared using univariate and multivariate analyses., Results: A total of 3,107,471 patients were discharged with a primary diagnosis of GI bleeding during the study period. Of these, 6569 (0.21%) had CF-LVAD-related GI bleeding. Overall, bleeding angiodysplasia accounted for the majority (69%) of LVAD-related GI bleeding. There was no statistical difference in mortality, but the length of hospital stay increased by 2.53 days (95% confidence interval [CI] 1.78-2.98; P<0.001) and the mean hospital charge per stay increased by $25,980 (95%CI 21,267-29,874; P<0.001) in 2017 compared to 2008. The results were consistent after propensity score matching., Conclusion: Our study highlights that patients with LVAD admitted to the hospital for GI bleeding experience longer hospital stays and greater healthcare costs that warrant risk-based patient evaluation and careful implementation of management strategies., Competing Interests: Conflict of Interest: None, (Copyright: © Hellenic Society of Gastroenterology.)