Feasibility and diagnostic yield of small-bowel capsule endoscopy in patients with surgically altered gastric anatomy : the SAGA study
(2021) In Gastrointestinal Endoscopy 94(3). p.1-597- 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,... (More)
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.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2021-04-20
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Gastrointestinal Endoscopy
- volume
- 94
- issue
- 3
- pages
- 1 - 597
- publisher
- Elsevier
- external identifiers
-
- scopus:85107859315
- pmid:33848508
- ISSN
- 0016-5107
- DOI
- 10.1016/j.gie.2021.03.934
- language
- English
- LU publication?
- yes
- id
- 230a220a-c99d-451f-b86e-96f734f836be
- date added to LUP
- 2021-08-04 14:42:10
- date last changed
- 2024-09-22 21:55:23
@article{230a220a-c99d-451f-b86e-96f734f836be, abstract = {{<p>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.</p>}}, author = {{Dray, Xavier and Riccioni, Maria Elena and Wurm Johansson, Gabriele and Keuchel, Martin and Perrod, Guillaume and Martin, Antoine and Tortora, Annalisa and Nemeth, Artur and Baltes, Peter and Pérez-Cuadrado-Robles, Enrique and Chetcuti Zammit, Stefania and Lee, Phey Shen and Leenhardt, Romain and Koulaouzidis, Anastasios}}, issn = {{0016-5107}}, language = {{eng}}, month = {{04}}, number = {{3}}, pages = {{1--597}}, publisher = {{Elsevier}}, series = {{Gastrointestinal Endoscopy}}, title = {{Feasibility and diagnostic yield of small-bowel capsule endoscopy in patients with surgically altered gastric anatomy : the SAGA study}}, url = {{http://dx.doi.org/10.1016/j.gie.2021.03.934}}, doi = {{10.1016/j.gie.2021.03.934}}, volume = {{94}}, year = {{2021}}, }