Abstract
Background and study aims Capsule endoscopy (CE) is a diagnostic
tool mainly used to explore the small bowel (SB), whereas device-assisted enteroscopy (DAE) is
preferred for therapeutics. We aimed to describe the procedure load of SB endoscopy in France
from 2015 to 2021.
Patients and methods Using the French national health data system
and the French national hospital discharge database, we identified all SBCEs and DAEs reported
between January 2015 and December 2021. Information on DAEs was crosschecked with data on
purchase or maintenance from manufacturers. Centers and procedures were described by type,
year, type of practice, and according to the 13 French administrative regions in the mainland
and in those overseas.
Results A total of 151,096 SBCEs and 6,802 for DAEs were
considered over the study period. SBCE service was offered in all regions, in both public and
private settings, and the case load increased from 18,956 to 24,183 (+27.6%). The number of
DAEs decreased nationwide, from 1,030 to 932 (–9.5%). Eighty-seven percent of all DAEs were
performed in public university hospitals. Retrograde route varied between 18.8% and 22.8% of
all DAEs yearly. The number of centers offering DAE varied from 0 to 5, over regions and
years. DAE caseloads increased in five regions but ended, decreased or the procedure was not
yet used in the nine remaining regions.
Conclusions SB endoscopy in France is marked by a 22-fold
unbalanced procedure load in CE (nationwide coverage) and in DAE (absent in some regions).
This gap has widened over the years from 2015 to 2021.
Keywords
Capsule endoscopy - Small bowel endoscopy - Epidemiology
