Feasibility and diagnostic yield of small-bowel capsule endoscopy in patients with surgically altered gastric anatomy: the SAGA study.

Autor: Dray X; Sorbonne University, Saint Antoine Hospital, Paris, France., Riccioni ME; Fondazione Policlinico A. Gemelli-IRCCS, Rome, Italy., Wurm Johansson G; Skåne University Hospital, Lund University, Malmö, Sweden., Keuchel M; Asklepios Klinik Altona, Hamburg, Germany., Perrod G; Georges-Pompidou European Hospital, AP-HP Centre, Université de Paris, Paris, France., Martin A; Université Paris-Est Créteil, Henri Mondor Hospital, Créteil, France., Tortora A; Fondazione Policlinico A. Gemelli-IRCCS, Rome, Italy., Nemeth A; Skåne University Hospital, Lund University, Malmö, Sweden., Baltes P; Agasplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany., Pérez-Cuadrado-Robles E; Georges-Pompidou European Hospital, AP-HP Centre, Université de Paris, Paris, France; Morales Meseguer Hospital, Murcia, Spain., Chetcuti Zammit S; Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK., Lee PS; South Tyneside District Hospital, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK., Leenhardt R; Sorbonne University, Saint Antoine Hospital, Paris, France., Koulaouzidis A; Royal Infirmary of Edinburgh, Edinburgh, UK; Pomeranian Medical University, Szczecin, Poland.
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2021 Sep; Vol. 94 (3), pp. 589-597.e1. Date of Electronic Publication: 2021 Apr 20.
DOI: 10.1016/j.gie.2021.03.934
Abstrakt: 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.
(Copyright © 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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