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Role of intraoperative enteroscopy in the management of obscure gastointestinal bleeding at the time of video-capsule endoscopy.
- Source :
-
American journal of surgery [Am J Surg] 2009 Jul; Vol. 198 (1), pp. 6-11. Date of Electronic Publication: 2009 Apr 25. - Publication Year :
- 2009
-
Abstract
- Background: This study aimed at evaluating the role of intraoperative enteroscopy (IOE) for the management of obscure gastrointestinal (GI) bleeding in patients who had been preoperatively explored by video-capsule endoscopy (VCE).<br />Methods: Eighteen patients who underwent IOE for obscure GI bleeding were prospectively recorded between November 2000 and January 2007. The bleeding site was preoperatively localized by VCE in the small bowel in 15 patients, but the origin of bleeding remained unknown in 3 patients.<br />Results: In the 3 patients with negative VCE, IOE was normal, but intraoperative conventional endoscopy identified gastric (n = 1) and colonic (n = 2) lesions. Among the 15 patients with VCE positive for small-bowel lesions, laparotomy and IOE yielded localization and treatment (surgical n = 11 and endoscopic n = 2) guidance for 13 of 15 (87%) lesions. At median 19-month follow-up, 3 bleeding recurrences (3 of 15 [20%]) were recorded, resulting in a 73% therapeutic efficacy of IOE.<br />Conclusions: IOE remains useful for the management of obscure GI bleeding when preoperative VCE is positive for small-bowel lesions that are not reachable by nonoperative enteroscopy. When VCE is negative, new conventional endoscopy should be proposed instead of IOE.
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Gastrointestinal Hemorrhage diagnosis
Humans
Intestinal Diseases diagnosis
Male
Middle Aged
Prospective Studies
Treatment Outcome
Capsule Endoscopy methods
Gastrointestinal Hemorrhage surgery
Hemostasis, Endoscopic methods
Intestinal Diseases surgery
Intestine, Small
Intraoperative Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1883
- Volume :
- 198
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 19393986
- Full Text :
- https://doi.org/10.1016/j.amjsurg.2008.06.036