Skip to main content
SpringerLink
Log in

Small-Bowel Capsule Endoscopy in Clinical Practice: Has Anything Changed Over 13 Years?

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

In Lombardia, one of the 20 Italian administrative Regions, small-bowel capsule endoscopy (SBCE) was introduced in 2001. In January 2011, the Regional Health Authorities established a reimbursement for outpatient SBCE.

Aim

To prospectively record data on SBCE between 2011–2013 and compare them to similar data retrospectively collected from the same geographical area (covering the period 2001–2008) and published in 2008.

Methods

Consecutive SBCEs performed between January 2011 and December 2013 in Lombardia were prospectively collected.

Results

In 3 years, 3142 SBCEs were collected; the diagnostic yield (DY) and the overall complication rate were 48.4 and 0.9%, respectively. The main indication was suspected small-bowel bleeding (76.6% of patients); complete small-bowel inspection was achieved in 2796 (89.0%) patients. SBCE was performed as an outpatient procedure in 1945 patients (61.9%). A significant increase in the rate of patients undergoing SBCE for suspected small-bowel bleeding was observed from 2001–2008 to 2011–2013 (67.3 vs. 76.1%; p < 0.001). There was an increase in the number of complete small-bowel examinations (81.2 vs. 89.0%; p < 0.001) and of outpatient SBCEs (6.7 vs. 61.9%; p < 0.001). Conversely, both the retention rate (2.1 vs. 0.8%; p < 0.001) and the rate of patients undergoing SBCE for Crohn’s disease (11.5 vs. 5.5%; p < 0.001) decreased significantly. The overall DY remained stable (50.6 vs. 48.4%; p = 0.089).

Conclusion

Our study shows that, over 13 years, the SBCE safety profile and completion rate significantly improved over time; a change in the spectrum of clinical indications was also observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Katsinelos P, Chatzimavroudis G, Terzoudis S, et al. Diagnostic yield and clinical impact of capsule endoscopy in obscure gastrointestinal bleeding during routine clinical practice: a single-center experience. Med Princ Pract. 2011;20:60–65.

    Article  PubMed  Google Scholar 

  2. Sidhu R, Sanders DS, Kapur K, et al. Capsule endoscopy changes patient management in routine clinical practice. Dig Dis Sci. 2007;52:1382–1386.

    Article  PubMed  Google Scholar 

  3. Li F, Gurudu SR, De Petris G, et al. Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures. Gastrointest Endosc. 2008;68:174–179.

    Article  PubMed  Google Scholar 

  4. Johnston CA, Yung DE, Joshi A, et al. Small bowel malignancy in patients undergoing capsule endoscopy at a tertiary care academic center: case series and review of the literature. Endosc Int Open. 2017;5:E463–E470.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Yung DE, Rondonotti E, Giannakou A, et al. Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy. United Eur Gastroenterol J. 2017;5:974–981.

    Article  Google Scholar 

  6. Hoog CM, Bark LA, Arkani J, et al. Capsule retention and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract. 2012;2012:518718.

    Article  PubMed  Google Scholar 

  7. Liao Z, Gao R, Xu C, et al. Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc. 2010;71:280–286.

    Article  PubMed  Google Scholar 

  8. Rondonotti E, Soncini M, Girelli CM, et al. Small bowel capsule endoscopy in clinical practice: a multicenter 7 year survey. Eur J Gastroenterol Hepatol. 2010;22:1380–1386.

    Article  PubMed  Google Scholar 

  9. Rondonotti E, Soncini M, Girelli CM, et al. Can we improve detection rate and interobserver agreement in capsule endoscopy? Results of a training among readers with different experience. Dig Liver Dis. 2012;44:1006–1011.

    Article  PubMed  Google Scholar 

  10. Rondonotti E, Soncini M, Girelli CM, et al. Cost estimation of small bowel capsule endoscopy based on “real world” data: inpatient or outpatient procedure? Dig Liver Dis. 2010;42:798–802.

    Article  PubMed  Google Scholar 

  11. Soncini M, Russo A, Campi E, et al. Capsule endoscopy of the small bowel in the clinical practice: outpatient management is feasible and cheaper. Minerva Gastroenterol Dietol. 2010;56:383–387.

    PubMed  CAS  Google Scholar 

  12. http://www.buongiornocreg.it/assets/DGR_IX_937_01_12_2010.pdf. 2018 Last Accessed 24.03.2018.

  13. Saurin JC, Delvaux M, Gaudin JL, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push enteroscopy. Endoscopy. 2003;35:576–584.

    Article  PubMed  Google Scholar 

  14. Rondonotti E, Soncini M, Girelli CM, et al. Short article: negative small-bowel cross-sectional imaging does not exclude capsule retention in high-risk patients. Eur J Gastroenterol Hepatol. 2016;28:871–875.

    Article  PubMed  Google Scholar 

  15. Pennazio M, Spada C, Eliakim R, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2015;47:352–376.

    Article  PubMed  Google Scholar 

  16. Robinson CA, Jackson C, Condon D, et al. Impact of inpatient status and gender on small-bowel capsule endoscopy findings. Gastrointest Endosc. 2011;74:1061–1066.

    Article  PubMed  Google Scholar 

  17. Ribeiro I, Pinho R, Rodrigues A, et al. What is the long-term outcome of a negative capsule endoscopy in patients with obscure gastrointestinal bleeding? Rev Esp Enferm Dig. 2015;107:753–758.

    PubMed  Google Scholar 

  18. Matsumura T, Arai M, Saito K, et al. Predictive factor of re-bleeding after negative capsule endoscopy for obscure gastrointestinal bleeding: over 1-year follow-up study. Dig Endosc. 2014;26:650–658.

    Article  PubMed  Google Scholar 

  19. Riccioni ME, Urgesi R, Cianci R, et al. Negative capsule endoscopy in patients with obscure gastrointestinal bleeding reliable: recurrence of bleeding on long-term follow-up. World J Gastroenterol. 2013;19:4520–4525.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nemeth A, Kopylov U, Koulaouzidis A, et al. Use of patency capsule in patients with established Crohn’s disease. Endoscopy. 2016;48:373–379.

    PubMed  Google Scholar 

  21. Nakamura M, Hirooka Y, Yamamura T, et al. Clinical usefulness of novel tag-less Agile patency capsule prior to capsule endoscopy for patients with suspected small bowel stenosis. Dig Endosc. 2015;27:61–66.

    Article  PubMed  Google Scholar 

  22. Rezapour M, Amadi C, Gerson LB. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc. 2017;85:1157–1168.

    Article  PubMed  Google Scholar 

  23. Gerson LB, Fidler JL, Cave DR, et al. ACG Clinical Guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110:1265–1287.

    Article  PubMed  CAS  Google Scholar 

  24. Enns RA, Hookey L, Armstrong D, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152:497–514.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Silvia Paggi for her invaluable help in the editing process.

Author information

Authors and Affiliations

  1. Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliera S. Carlo Borromeo, Via Pio II, 3, 20153, Milan, Italy

    Marco Soncini

  2. Gastroenterology and Digestive Endoscopy Unit, Hospital of Busto Arsizio, Busto Arsizio, Varese, Italy

    Carlo Maria Girelli

  3. University of Milan, Milan, Italy

    Roberto de Franchis

  4. Gastroenterology Unit, Ospedale Valduce, Como, Italy

    Emanuele Rondonotti

Authors
  1. Marco Soncini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlo Maria Girelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto de Franchis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emanuele Rondonotti
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

SBCE Lombardia Study Group

On behalf AIGO, SIED and SIGE Lombardia

Corresponding author

Correspondence to Marco Soncini.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Additional information

Members of the “SBCE Lombardia study group” are listed in “Appendix”.

Appendix

Appendix

See Table 2.

Table 2 List of gastroenterologists participating in the “SBCE Lombardia study group.” In some centers more than one gastroenterologist was involved
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soncini, M., Girelli, C.M., de Franchis, R. et al. Small-Bowel Capsule Endoscopy in Clinical Practice: Has Anything Changed Over 13 Years?. Dig Dis Sci 63, 2244–2250 (2018). https://doi.org/10.1007/s10620-018-5101-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-018-5101-9

Keywords

Search

Navigation