A randomized controlled trial of a through-the-scope stiffening wire to increase the depth of insertion during double-balloon enteroscopy

Background and aims: We investigated whether use of a stiffening wire increased insertion depth during double-balloon enteroscopy (DBE).

Methods: A total of 54 patients were randomized to the stiffening wire or the control group after reaching the maximum insertion depth using a conventional technique. Further advancement was then attempted. The primary outcome was the distance gained after randomization. Secondary outcomes included total insertion depth, diagnostic and intervention rates, pain scores, and adverse events.

Results: The median insertion distance after randomization was higher in the stiffening wire group compared with the control group (135 vs 19 cm; P < .001), as was the total insertion depth (502 vs 391 cm; P = .015). There were no differences in diagnostic or intervention rates or pain scores. Two adverse events occurred in the stiffening wire arm but were unrelated to the wire.

Conclusions: The stiffening wire increased insertion depth and should be used when an abnormality cannot be reached with a conventional technique. (Clinical trial registration number: NCT02720848.).