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Randomized Controlled Trial
. 2022 Aug-Sep;46(7):101921.
doi: 10.1016/j.clinre.2022.101921. Epub 2022 Apr 4.

Small bowel capsule endoscopy in obscure gastrointestinal bleeding: A matched cohort comparison of patients with normal vs surgically altered gastric anatomy

Xavier Dray  1 , Gabriel Rahmi  2 , Maria Elena Riccioni  3 , Geoffroy Vanbiervliet  4 , Gabriele Wurm Johansson  5 , Chloé Leandri  6 , Peter Baltes  7 , Clotilde Duburque  8 , Franck Cholet  9 , Anastasios Koulaouzidis  10 , Lucille Quénéhervé  9 ; I-CARE group and the PREPINTEST study group
Affiliations
Randomized Controlled Trial

Small bowel capsule endoscopy in obscure gastrointestinal bleeding: A matched cohort comparison of patients with normal vs surgically altered gastric anatomy

Xavier Dray et al. Clin Res Hepatol Gastroenterol. 2022 Aug-Sep.

Abstract

Background: Little is known about small bowel capsule endoscopy (SBCE) outcomes in patients with surgically altered anatomy.

Aims: To assess the feasibility and diagnostic yield of orally ingested SBCE to investigate obscure gastrointestinal bleeding (OGIB) in patients with surgically altered gastric anatomy, compared to native gastric anatomy.

Methods: 207 patients with OGIB were selected from an open, multicenter, retrospective cohort (SAGA study) and match-paired according to age, gender and bleeding type (overt/occult) to 207 control patients from a randomized controlled trial (PREPINTEST). Primary outcomes were the diagnostic yield (P1 or P2 findings), completion rate, adverse events rate, and small bowel transit time (SBTT).

Results: The diagnostic yield was not statistically different between groups (44.9% in SAGA vs 42.5% in control patients). Inflammatory/ulcerated lesions were significantly more frequent in patients with SAGA (43.0% vs 29.3%). The median SBTT was significantly longer in the SAGA group than in control patients (283 vs 206 minutes), with a significantly lower completion rate (82.6% vs 89.9%); Adverse events were scarce (0.5% vs 0.0%).

Conclusion: Patients with surgically altered gastric anatomy should benefit from SBCE investigation for OGIB as much as non-operated patients.

Keywords: Capsule endoscopy; Gastrectomy; Gastrointesintal bleeding; Small bowel bleeding.

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Conflict of interest statement

Declaration of Competing Interest The following authors disclosed financial relationships: X. Dray: Speaker for MSD, Pfizer, Medtronic, Bouchara Recordati, Fujifilm, Alfasigma, and Norgine; consultant for Alfasigma, Norgine, and Pentax; co-founder of and shareholder in Augmented Endoscopy; training and travel support from Ankon. G. Rahmi: personal fees from Fujifilm, Medtronic, and from Boston Scientific for an educational event. A. Koulaouzidis: Co-founder of AJM Medicaps; co-director of iCERV Ltd; travel support from Jinshan and Norgine; research support from ESGE/Given Imaging Ltd and IntroMedic/SynMed; F. Cholet: personal fees from Medtronic France for an educational event; All other authors disclosed no financial relationships. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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