SynthesisEuropean journal of pediatrics2026
Performance and safety of single-balloon enteroscopy and double-balloon enteroscopy for small-bowel disorders in children: a systematic review and meta-analysis.
Synthesis in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Single-balloon enteroscopy (SBE) and double-balloon enteroscopy (DBE) are widely used for diagnosing small-bowel disorders in adults. However, anatomical differences in children present unique challenges for operators. This meta-analysis evaluates the efficacy and safety of both techniques in pediatric patients, comparing results with adult data. A comprehensive literature search was performed to identify studies evaluating SBE and DBE in pediatric small-bowel disorders. Primary outcomes included diagnostic yield, therapeutic yield, and incidence of adverse events. Secondary outcomes included depth of maximal insertion (DMI), complete enteroscopy rate, and other relevant measures. A univariate random-effects meta-analysis was conducted. Twenty-four studies comprising 1463 patients were included. The pooled diagnostic yield was 0.72, therapeutic yield 0.61, oral DMI 211.6 cm, rectal DMI 137.9 cm, and complete enteroscopy rate 0.10. DBE achieved greater DMI and a higher complete enteroscopy rate than SBE, with other outcomes remaining comparable. The overall adverse event rate was 5.50%. Compared to data from adult meta-analyses, pediatric balloon enteroscopy (DBE and SBE) is associated with a lower rate of complete enteroscopy (0.44 in adults), a more limited depth of insertion (262 cm orally in adults), and a higher adverse event rate (2% in adults).
conclusionThis meta-analysis suggests that both SBE and DBE may be safe and effective for pediatric small-bowel disorders. However, outcomes in children, including shallower insertion, lower complete enteroscopy rates, and higher adverse events, differ from adults. Given the low certainty of evidence, these findings, particularly differences between techniques, are preliminary and require confirmation in future standardized studies.
trial registrationThe study protocol has been registered in PROSPERO ( https://www.crd.york.ac.uk/prospero ) under the registration number CRD420251131086. WHAT IS KNOWN: • Balloon enteroscopy (DBE and SBE) is well-established for small-bowel diseases in adults. • Due to anatomical differences, balloon enteroscopy faces challenges in pediatric applications, and its performance and safety in children remain uncertain. WHAT IS NEW: • This first meta-analysis to directly compare SBE and DBE in children demonstrates comparable diagnostic and therapeutic yields. • Pediatric procedures are associated with lower complete enteroscopy rates, shallower insertion, and higher adverse event rates compared to adults.
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