Endoscopy 2021; 53(S 01): S7
DOI: 10.1055/s-0041-1724266
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Feasibility and Diagnostic Yield of Small Bowel Capsule Endoscopy in Patients with Surgically Altered Gastric Anatomy

X Dray
1   Sorbonne University, Hôpital Saint Antoine, APHP, Center for Digestive Endoscopy, Paris, France
,
ME Riccioni
2   Fondazione Policlinico A.Gemelli-IRCCS, Roma, Italy
,
G Wurm Johansson
3   Skåne University Hospital, Lund University, Malmö, Sweden
,
M Keuchel
4   Asklepios Klinik Altona, Hamburg, Germany
,
G Perrod
5   Georges-Pompidou European Hospital, AP-HP Centre - Université de Paris, Paris, France
,
A Martin
6   Université Paris-Est Créteil, Henri Mondor Hospital, Créteil, France
,
A Tortora
2   Fondazione Policlinico A.Gemelli-IRCCS, Roma, Italy
,
A Nemeth
3   Skåne University Hospital, Lund University, Malmö, Sweden
,
P Baltes
7   Agasplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
,
E Pérez-Cuadrado-Robles
8   Morales Meseguer Hospital, Murcia, Spain
5   Georges-Pompidou European Hospital, AP-HP Centre - Université de Paris, Paris, France
,
S Chetcuti Zammit
9   Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, United Kingdom
,
PS Lee
10   South Tyneside District Hospital, South Tyneside and Sunderland NHS Foundation Trust, South Shields, United Kingdom
,
S Cadoni
11   CTO Hospital, Iglesias, Italy
,
I Fernández-Urien Sainz
12   Complejo Hospitalario de Navarra, Pamplona, Spain
,
D McNamara
13   TAGG Research Centre, School of Medicine, Trinity College, Dublin, Ireland
,
R Margalit-Yehuda
14   Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
,
H Beaumont
15   Amsterdam Universitair Medische Centres, Amsterdam, Netherlands
,
A Mussetto
16   Santa Maria delle Croci Hospital, Ravenna, Italy
,
C Spada
17   Università Cattolica del Sacro Cuore, Roma, Italy
18   Fondazione Poliambulanza, Brescia, Italy
,
L Elli
19   Mater Dei Hospital, Msida, Malta
,
M Bruno
20   Azienda Ospedaliera Città della Salute e della Scienza, Turino, Italy
,
E Rondonotti
21   Ospedale Valduce, Como, Italy
,
A Robertson
22   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
P Cortegoso Valdivia
23   University Hospital of Parma, University of Parma, Parma, Italy
,
R Leenhardt
1   Sorbonne University, Hôpital Saint Antoine, APHP, Center for Digestive Endoscopy, Paris, France
24   European Capsule Endoscopy Working Group, tbd, France
,
O.b.o. the European Capsule Endoscopy Working Group,
A Koulaouzidis
22   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
25   Department of Social Medicine and Public Health, Faculty of Health Sciences, Pomeranian Medical University, Szczecin, Poland
› Author Affiliations
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    Aims Little is known about small bowel (SB) capsule endoscopy (CE) in patients with a history of gastric surgery. This study aims to evaluate the feasibility and the diagnostic yield (DY) of orally ingested SB-CE in patients with altered gastric anatomy.

    Methods 24 European centers retrospectively identified patients who had SB-CE after total or partial gastrectomy. The primary outcome was the diagnostic yield (DY) of SB-CE (intermediate P1 to highly P2 relevant findings). Secondary outcomes were gastric and SB transit times, completion, cleanliness, and adverse events rates.

    Results 248 procedures from 243 patients (mean age 62 years) with a history of subtotal gastrectomy (47.7 %), total gastrectomy (7.4 %), Whipple procedure (12.8 %), sleeve gastrectomy (7.2 %), or gastric bypass surgery (24.7 %); obscure gastrointestinal bleeding was the most frequent (85.1 %) indication. SB completion rate was 84.3 %. One capsule retention in the SB was noted (adverse event rate 0.4 %). Median SB transit time was 286 min (interquartile range [235;387]). Cleanliness was rated adequate in 92.1 % of procedures.

    After exclusion of lesions found at the upper anastomotic site, the DY was 44.5 %, with vascular lesions in 47.3 % of positive cases, followed by inflammatory/ulcerated lesions (21.6 %), polyps/masses (4.8 %), and blood (3.1 %). Patients with a history of bariatric surgery had significantly lower DY of P1 or P2 lesions (28.2 %) compared to those with non-bariatric gastric surgeries (51.2 %) (p<0.001). In the subgroup of patients with partial gastrectomy, those with Billroth II operation had a higher DY of P1 or P2 lesions (54.7 %) compared to those with Billroth I surgery (40.6 %) (p = 0.17).

    Conclusions SB-CE seems feasible and safe in selected patients with a history of major gastric surgery, and it comes with a high DY.

    Citation: Dray X, Riccioni ME, Wurm Johansson G et al. OP6 FEASIBILITY AND DIAGNOSTIC YIELD OF SMALL BOWEL CAPSULE ENDOSCOPY IN PATIENTS WITH SURGICALLY ALTERED GASTRIC ANATOMY. Endoscopy 2021; 53: S7.


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    Publication History

    Article published online:
    19 March 2021

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