Double-balloon enteroscopy in different age groups: indications, findings, diagnosis, and treatment: A 17-year single-center retrospective cohort study.
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Double-balloon enteroscopy (DBE) is an essential diagnostic and therapeutic modality for small-bowel disorders. Most prior studies on age-related differences in DBE involved limited age groups and small cohorts. We evaluated age-specific differences in the indications, findings, therapeutic interventions, and complications of DBE in a large single-center cohort. We retrospectively analyzed 817 patients who underwent 1101 DBE procedures between January 2006 and January 2023 at a tertiary center. The patients were grouped as young (18-44 years), middle-aged (45-64 years), and elderly (≥65 years). Demographics, indications, endoscopic and pathological findings, interventions, and complications were compared among groups. Bleeding was the most frequent indication in elderly patients, whereas diarrhea, abdominal pain, inflammatory bowel disease, and polyposis syndromes were more common in younger patients. Inflammatory lesions and polyps predominated in younger patients, whereas vascular lesions and tumors were more frequent in elderly patients (P < .05). Diagnostic interventions predominated in young and middle-aged patients, whereas therapeutic interventions were more common in the elderly (P < .001). Benign and malignant neoplasms were more common in the elderly, whereas celiac disease and polyposis syndrome were more common in younger individuals (P < .05). The overall complication rate was 2.6%, with a higher but nonsignificant rate of anesthesia-related complications in the elderly (P = .11). DBE is safe and effective in all age groups. Age was significantly associated with clinical indications and endoscopic findings, and recognizing these patterns can guide more targeted use of DBE and improve diagnostic accuracy.