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

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.

• Authors: Xavier Dray, Gabriel Rahmi, Maria Elena Riccioni, Geoffroy Vanbiervliet, Gabriele Wurm Johansson, Chloé Leandri, Peter Baltes, Clotilde Duburque, Franck Cholet, Anastasios Koulaouzidis, Lucille Quénéhervé, I-CARE group and the PREPINTEST study group
• Journal: Clinics and research in hepatology and gastroenterology (Clin Res Hepatol Gastroenterol) 2022 Aug-Sep Vol. 46 Issue 7 Pg. 101921 ISSN: 2210-741X [Electronic] France
• PMID: 35390539 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Topics

• Capsule Endoscopy
• Gastrointestinal Hemorrhage (diagnosis, etiology, pathology)
• Humans
• Intestine, Small (pathology, surgery)
• Retrospective Studies
• Stomach (surgery)