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Intraoperative enteroscopy

Ten years’ experience at a single tertiary center

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Abstract

Background and methods

Intraoperative enteroscopy is an invasive technique for small bowel investigation. It enables us to investigate the entire small intestine and to treat pathological findings by endoscopic or surgical means at the same time. The investigation is invasive and that is why the proper indication is mandatory.

Results

Forty-one intraoperative enteroscopies were performed at our center within a 10-year period. The procedure was diagnostic in 37/41 patients (90.2%); in 3 patients no pathology was found, and in 1 patient we found only previously diagnosed celiac disease. The investigation was therapeutic in 35/41 (85.4%) patients; 2 patients with small bowel ulcers did not require any intraoperative therapy. The pathological findings were arteriovenous malformations (found in 12 patients), small bowel NSAID-induced or Crohn’s ulcers (8 patients)—ulcerations and arteriovenous malformations were simultaneously found in three patients; carcinoid of the small intestine (5 patients); Peutz-Jeghers syndrome (5 patients); bleeding polyps (2 gastrointestinal stromal tumors, 1 paraganglioma, and 1 lipoma—in 4 patients); Rendu-Osler-Weber disease (2 patients); multiple cavernous hemangiomas in blue rubber bleb nevus syndrome (1 patient); Henoch-Schönlein purpura (1 patient); aortoenteral fistula (1 patient); and retrograde intussusception of Meckel’s diverticulum (1 patient). In five patients with Peutz-Jeghers syndrome, 6-22 hamartomas (median of 18 per session) were removed by means of endoscopic polypectomy during intraoperative enteroscopy. There were no major procedure-related complications in our series.

Conclusions

Intraoperative enteroscopy is accepted as the ultimate diagnostic procedure for complete investigation of the small bowel. Despite the introduction of double-balloon enteroscopy into clinical practice, intraoperative enteroscopy will be reserved for those cases where double-balloon enteroscopy cannot be performed or fails to investigate the entire small intestine, especially to prevent excessive bowel resection.

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Acknowledgments

The study was supported by the research project: MZO 00179906 from the Ministry of Health, Czech Republic.

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Authors and Affiliations

  1. 2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, Hradec Králové, 500 05, Czech Republic

    M. Kopáčová, J. Bureš, I. Tachecí & S. Rejchrt

  2. Department of Surgery, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, Hradec Králové, 500 05, Czech Republic

    L. Vykouřil, P. Hladík, D. Šimkovič, B. Jon & A. Ferko

Authors
  1. M. Kopáčová
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  2. J. Bureš
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  4. P. Hladík
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  8. I. Tachecí
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  9. S. Rejchrt
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Corresponding author

Correspondence to M. Kopáčová.

Additional information

This work was presented in part at the 13th United European Gastroenterology Week, October 2005, Copenhagen, Denmark.

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Kopáčová, M., Bureš, J., Vykouřil, L. et al. Intraoperative enteroscopy. Surg Endosc 21, 1111–1116 (2007). https://doi.org/10.1007/s00464-006-9052-4

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  • DOI: https://doi.org/10.1007/s00464-006-9052-4

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