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Objectives: Single‐balloon enteroscopy (SBE) is an effective tool for the detection of small intestine lesions. Because it is conventionally performed by two operators, the efficacy of single‐operator SBE method has not yet been elucidated. We aimed to evaluate the diagnostic yield, total enteroscopy rate, procedure time, and complications of single‐operator SBE for small intestinal disease. Methods: This was a single‐center, retrospective study including consecutive patients who underwent single‐operator SBE for suspicious small intestinal disorders or required therapeutic interventions between December 2014 and January 2019. The SBE procedures were performed by four endoscopists. Diagnostic yield, total enteroscopy rate, procedure time, incubation depth, and complications were analyzed, and stratification analysis was performed. Results: Altogether 922 patients with 1422 SBE procedures were included for analysis, among whom 250, 172, and 500 patients underwent SBE via the oral route, the anal route and a combined route, respectively. The overall diagnostic yield was 78.52% (724/922). And 253 patients achieved total enteroscopy, with a total enteroscopy rate of 56.10%. The average procedure time for the oral and anal routes were 69.28 ± 14.72 min and 64.95 ± 13.87 min, respectively. While the incubation depth was 389.95 ± 131.42 cm and 191.81 ± 83.67 cm, respectively. Jejunal perforation was observed in one patient, which was managed by endoclips. Stratification analysis showed that the diagnostic yield and total enteroscopy rate significantly increased with operation experience together with decreased procedure time. Conclusion: Single‐operator SBE is effective and safe for the detection of small intestinal lesions, and is easy to master. [ABSTRACT FROM AUTHOR]

Background: Low‐grade inflammation may be involved in the pathogenesis of functional dyspepsia (FD). We hypothesis that altered gastric permeability is involved in the onset and persistence of this disorder. Therefore, our aim was to evaluate gastric mucosal integrity and mast cell numbers in patients with FD. Methods: We enrolled 58 patients with FD fulfilling the Rome III criteria (H Pylori negative), 20 inflammatory control subjects (H Pylori positive), and 20 healthy controls (H Pylori negative). Probe‐based confocal endomicroscopy was performed using intravenous fluorescein to assess the paracellular fluorescein leakage and cell shedding. Mast cells were identified with quantitative immunohistochemistry on mucosal biopsies. Key Results: Endomicroscopic score of paracellular permeability was significantly higher in H pylori‐negative FD patients compared with healthy controls (1.45 ± 1.27 vs 3.69 ± 3.18, P =.006). However, FD patients and healthy controls did not show differences in cell shedding score (0.75 ± 0.79 vs 1.29 ± 1.14, P =.069). Mast cell numbers were significantly increased compared with healthy control samples (18.91 ± 5.47 vs 14.1 ± 3.88, P <.001). The magnitude of increase in permeability was positively correlated with mast cell numbers of FD patients (rs =.6588, P <.0001), but not dyspepsia symptom scores. Conclusion and Inferences: Impaired gastric barrier function is present in FD patients. This might provide a new pathophysiological mechanism and therapeutical target in FD. [ABSTRACT FROM AUTHOR]