Intraoperative endoscopy through enterotomy for overt obscure gastrointestinal bleeding: A retrospective cohort study

Introduction: Overt obscure gastrointestinal bleeding (OGIB) is challenging and often needs intraoperative endoscopy (IOE) with a high risk of morbidity and mortality. The study was to compare the different approaches to perform IOE for overt OGIB. Patients and methods: We retrospectively reviewed the data of 98 patients who underwent trans-enterotomy IOE (IOE-E) or other approaches such as peroral IOE (IOE-oral), trans-anal IOE (IOE-anal), or combined route (IOEcombo). Patient characteristics, demographics, diagnostic tests, IOE findings, and follow-up outcomes were analyzed. Results: All 98 patients underwent IOE. There are 31 patients in the IOE-E group, 26 patients in the IOE-oral group, 23 patients in the IOE-anal group, and 18 patients in the IOE-combo group, respectively. Long-term follow-up information (> 6 months) was successfully obtained in 72 patients. IOE-E has the lowest postoperative morbidity rate (16%, P < 0.05), the shortest time of operation (43.2 +/- 17.4 min, P < 0.05) and shortest hospital length of stay (6.7 ?+/-& nbsp;5.1 days, P < 0.05), as compared to the other three approaches. Conclusions: Intraoperative endoscopy through enterotomy represents a safer and more ideal strategy in the management of overt OGIB.