Diagnostic and therapeutic yield is not influenced by the timing of small-bowel enteroscopy: morning versus afternoon

Abstract

Background: Small-bowel enteroscopies (BEs) are tedious and prolonged, and their efficacy may be affected by the timing of procedures.

Objective: We aimed to evaluate the differences in diagnostic yield, insertion depth, procedure duration, therapeutic yield, and adverse events (AEs) of enteroscopies performed in the morning versus the afternoon.

Design: Retrospective cohort study.

Setting: Tertiary referral center.

Patients: Patients who underwent BE for suspected small-bowel disease at a single institution between January 2008 and August 2009.

Main outcome measurement: Differences in diagnostic yield, insertion depth, procedure duration, therapeutic yield, and AEs between morning (started before noon) and afternoon (after noon) procedures.

Results: A total of 250 enteroscopies were performed on 250 patients, of which 125 patients (50%) underwent a procedure in the morning and 125 patients (50%) underwent the procedure in the afternoon. The diagnostic yield with anterograde enteroscopy was the same in both the morning and afternoon (63.7% and 63.7%, respectively; P = .99). The procedure durations were also similar (42.4 ± 21.5 minutes vs 46.2 ± 22.4 minutes, respectively; P = .25). Similarly the diagnostic yield with retrograde enteroscopy was similar in morning and afternoon (44.1% and 35.3%, respectively; P = .46). However, the procedure durations of retrograde BE were significantly shorter in the morning compared with the afternoon (51.3 ± 21.3 minutes vs 66.6 ± 32.9 minutes, respectively; P = .03). Therapeutic yield and AEs were similar.

Limitations: Retrospective study.

Conclusions: The timing of procedure, morning versus afternoon, did not affect the diagnostic and therapeutic efficacy of BE in patients with suspected small-bowel disease.