Sa1699 Management of Small Intestinal Stenoses: Single Tertiary Centre Experience

diagnosis of HPS was confirmed by standard clinical criteria and genetic testing. Data were abstracted for patient demographics, radiologic studies, DBE findings, procedural outcomes, and complications. Results: Twenty-two patients (50% men; 19 PJS; 2 CS; 1JPS) with mean age of 37 14 yrs underwent a total of 34 DBE procedures. Seventeen (77%) patients had prior SB surgeries. There were 4 (18%) patients with a history of SB obstruction, 10 (45%) with prior intussusception, and 5 (23%) with HPS-related SB bleeding. Pre-DBE imaging included CT enterography (n 15), CT enteroclysis (n 5), small bowel follow through (n 1), and MR enterography (n 1). Any SB polyp 1cm in size was targeted for DBE-assisted polypectomy. The estimated location of polyps on imaging studies directed the DBE route of approach (antegrade (A) and/or retrograde (R)). A-DBE (n 20) and R-DBE (n 14) procedures averaged 2.6 0.8 hrs and 2.3 0.8 hrs, respectively (p 0.46). Fluoroscopy was utilized in 70% of A-DBE and 50% of R-DBE procedures. The maximal insertion depth was estimated to be the distal jejunum and proximal ileum in 65% and 35% of ADBE, respectively. R-DBE reached the distal jejunum in 21% of retrograde procedures. A-DBE and R-DBE were successful in reaching and resecting targeted polyps in 90% (18/20) and 71.4% (10/14) of procedures, respectively. The overall success rate for DBE-assisted polypectomy was 82.3% (95% CI: 66.591.6%). The median size of resected polyps was 2cm (range 1-5cm) and all were hamartomas. Unsuccessful procedures were due to failure to locate the polyp (n 1), failure to advance the enteroscope in the SB (n 2), failure to intubate the terminal ileum (n 2), and poor colon preparation (n 1). Complications occurred in 11.8% of procedures and included abdominal pain requiring overnight hospitalization (n 2), immediate post-polypectomy bleeding requiring clip placement (n 1), and self-limited hematochezia (n 1). Conclusions: DBEassisted polypectomy was successful in over 80% of HPS patients with an acceptable margin of safety. To our knowledge, this is the largest single-center experience to report on the performance and safety of DBE-assisted polypectomy in HPS patients.