Background
Capsule endoscopy (CE) has been widely used in clinical practice.
Objective
To provide systematically pooled results on the indications and detection, completion,
and retention rates of small-bowel CE.
Design
A systematic review.
Main Outcome Measurements
We searched the PubMed database (2000-2008) for original articles relevant to small-bowel
CE for the evaluation of patients with small-bowel signs and symptoms. Data on the
total number of capsule procedures, the distribution of different indications for
the procedures, the percentages of procedures with positive detection (detection rate),
complete examination (completion rate), or capsule retention (retention rate) were
extracted and/or calculated, respectively. In addition, the detection, completion,
and retention rates were also extracted and/or calculated in relation to indications
such as obscure GI bleeding (OGIB), definite or suspected Crohn's disease (CD), and
neoplastic lesions.
Results
A total of 227 English-language original articles involving 22,840 procedures were
included. OGIB was the most common indication (66.0%), followed by the indication
of only clinical symptoms reported (10.6%), and definite or suspected CD (10.4%).
The pooled detection rates were 59.4%; 60.5%, 55.3%, and 55.9%, respectively, for
overall, OGIB, CD, and neoplastic lesions. Angiodysplasia was the most common reason
(50.0%) for OGIB. The pooled completion rate was 83.5%, with the rates being 83.6%,
85.4%, and 84.2%, respectively, for the 3 indications. The pooled retention rates
were 1.4%, 1.2%, 2.6%, and 2.1%, respectively, for overall and the 3 indications.
Limitations
Inclusion and exclusion criteria were loosely defined.
Conclusions
The pooled detection, completion, and retention rates are acceptable for total procedures.
OGIB is the most common indication for small-bowel CE, with a high detection rate
and low retention rate. In addition, angiodysplasia is the most common finding in
patients with OGIB. A relatively high retention rate is associated with definite or
suspected CD and neoplasms.
Abbreviations:
CD (Crohn's disease), CE (capsule endoscopy), OGIB (obscure GI bleeding)To read this article in full you will need to make a payment
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References
- Wireless capsule endoscopy.Nature. 2000; 405: 417
- Capsule enteroscopy of the small intestine.Abdom Imaging. 2009; 34: 452-458
- Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures.Gastrointest Endosc. 2008; 68: 174-180
- The utility of capsule endoscopy and its role for diagnosing pathology in the gastrointestinal tract.Am J Surg. 2005; 190: 886-890
- Capsule endoscopy changes patient management in routine clinical practice.Dig Dis Sci. 2007; 52: 1382-1386
- Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.Endoscopy. 2007; 39: 1046-1052
- Small bowel exploration by wireless capsule endoscopy: results from 314 procedures.Am J Med. 2006; 119: 341-347
- Wireless capsule endoscopy indication as a predictor of study quality.Dig Dis Sci. 2008; 53: 1898-1901
- Diagnostic detection rate and safety of capsule endoscopy.Rev Esp Enferm Dig. 2006; 98: 666-673
- Complications, limitations, and failures of capsule endoscopy: a review of 733 cases.Gastrointest Endosc. 2005; 62: 712-716
- AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding.Gastroenterology. 2000; 118: 201-221
- Wireless capsule endoscopy requiring surgical intervention: the world's experience.Am J Gastroenterol. 2002; 97: S298
- A pooled analysis to evaluate results of capsule endoscopy trials.Endoscopy. 2005; 37: 960-965
- A prospective trial comparing small-bowel radiographs and video capsule endoscopy for suspected small-bowel disease.Gastroenterology. 2002; 123: 999-1005
- Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study.Gastrointest Endosc. 2002; 56: 349-353
- The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.Endoscopy. 2002; 34: 685-689
- Metaanalysis: capsule enteroscopy vs. conventional modalities in diagnosis of small-bowel diseases.Aliment Pharmacol Ther. 2005; 22: 595-604
- Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases.Gastroenterology. 2004; 126: 643-653
- Diagnostic detection rate and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding.Eur J Gastroenterol Hepatol. 2006; 18: 881-888
- Capsule endoscopy in obscure gastrointestinal bleeding—an Indian experience.Indian J Gastroenterol. 2006; 25: 188-190
- Capsule endoscopy changes patient management in routine clinical practice.Dig Dis Sci. 2007; 52: 1382-1386
- Capsule endoscopy for obscure GI bleeding: therapeutic detection rate of follow-up procedures.Dig Dis Sci. 2007; 52: 1370-1375
- Capsule enteroscopy vs. other diagnostic procedures in diagnosing obscure gastrointestinal bleeding: a cost-effectiveness study.Eur J Gastroenterol Hepatol. 2007; 19: 535-542
- Wireless capsule endoscopy indication as a predictor of study quality.Dig Dis Sci. 2008; 53: 1898-1901
- Is there a role for second-look capsule endoscopy in patients with obscure GI bleeding after a nondiagnostic first test?.Gastrointest Endosc. 2009; 69: 850-856
- A meta-analysis of the detection rate of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small-bowel Crohn's disease.Am J Gastroenterol. 2006; 101: 954-964
- Capsule endoscopy findings in patients with established and suspected small-bowel Crohn's disease: correlation with radiologic, endoscopic, and histologic findings.Gastrointest Endosc. 2005; 62: 538-544
- Diagnosis of small-bowel Crohn's disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis.Gut. 2005; 54: 1721-1727
- Wireless capsule endoscopy indication as a predictor of study quality.Dig Dis Sci. 2008; 53: 1898-1901
- Prospective evaluation of small-bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy.World J Gastroenterol. 2008; 14: 2061-2064
- Intestinal perforation due to retained wireless capsule endoscope.Endoscopy. 2005; 37: 684
- Acute small-bowel perforation secondary to capsule endoscopy.Gastrointest Endosc. 2008; 67: 180-183
- Aspiration—an important complication of small-bowel video capsule endoscopy.Endoscopy. 2007; 39: E343
- Acute symptomatic small-bowel obstruction due to capsule impaction.Gastrointest Endosc. 2007; 65: 725-728
- The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease.Am J Gastroenterol. 2006; 101: 2218-2222
- Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery—diagnosis by capsule endoscopy: a report of two cases.Dig Liver Dis. 2003; 35: 577-584
Article info
Publication history
Accepted:
September 25,
2009
Received:
May 31,
2009
Shanghai, ChinaFootnotes
DISCLOSURE: This study was sponsored partly by the Shanghai Educational Development Foundation (Shanghai Chenguang Project, No. 2007CG49). All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr. Liao at [email protected]
Identification
Copyright
© 2010 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
