1. Feasibility and diagnostic yield of small-bowel capsule endoscopy in patients with surgically altered gastric anatomy: the SAGA study
- Author
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Dray, Xavier, Riccioni, Maria Elena, Wurm Johansson, Gabriele, Keuchel, Martin, Perrod, Guillaume, Martin, Antoine, Tortora, Annalisa, Nemeth, Artur, Baltes, Peter, Pérez-Cuadrado-Robles, Enrique, Chetcuti Zammit, Stefania, Shen Lee, Phey, Leenhardt, Romain, Koulaouzidis, Anastasio, CARE Group, I, Maria Elena Riccioni (ORCID:0000-0002-9239-4312), Annalisa Tortora, Dray, Xavier, Riccioni, Maria Elena, Wurm Johansson, Gabriele, Keuchel, Martin, Perrod, Guillaume, Martin, Antoine, Tortora, Annalisa, Nemeth, Artur, Baltes, Peter, Pérez-Cuadrado-Robles, Enrique, Chetcuti Zammit, Stefania, Shen Lee, Phey, Leenhardt, Romain, Koulaouzidis, Anastasio, CARE Group, I, Maria Elena Riccioni (ORCID:0000-0002-9239-4312), and Annalisa Tortora
- Abstract
Background and 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 diagnostic yield (DY) of orally ingested SB-CE in patients with surgically altered gastric anatomy. Methods: Twenty-four European centers retrospectively identified patients who had SB-CE after total or subtotal gastrectomy. The primary outcome was the DY of SB-CE (intermediate P1 to highly P2 relevant findings). Secondary outcomes were gastric and SB transit times, completion, cleanliness, and adverse event rates. Results: Studied were 248 procedures from 243 patients (mean age, 62 years) with a history of partial gastrectomy (Billroth I, 13.1%; Billroth II, 34.6%), total gastrectomy (7.4%), Whipple procedure (12.8%), sleeve gastrectomy (7.2%), or gastric bypass surgery (24.7%). Obscure GI bleeding was the most frequent indication (85.1%). SB completion rate was 84.3%. One capsule retention in the SB was noted (adverse event rate, .4%). Median SB transit time was 286 minutes (interquartile range [235; 387]). Cleanliness was rated as adequate in 92.1% of procedures. After exclusion of abnormalities found at the upper anastomotic site, the DY was 43.6%, with inflammatory/ulcerated lesions observed more frequently (23.4%) than vascular lesions (21.0%). Conclusions: SB-CE seems to be feasible and safe in selected patients with a history of major gastric surgery and comes with a high DY. The spectrum of abnormal SB findings in these patients may be different from what is known from the literature in nonoperated patients.
- Published
- 2021