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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(02): E163-E170
DOI: 10.1055/a-1319-1452
Review

Capsule endoscopy transit-related indicators in choosing the insertion route for double-balloon enteroscopy: a systematic review

Pablo Cortegoso Valdivia
1   Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
,
Karolina Skonieczna-Żydecka
2   Department of Human Nutrition & Metabolomics, Pomeranian Medical University in Szczecin, Szczecin, Poland
,
Marco Pennazio
3   University Division of Gastroenterology, City of Health and Science University Hospital, Turin, Italy
,
Emanuele Rondonotti
4   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
Wojciech Marlicz
5   Department of Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland
,
Ervin Toth
6   Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
,
Anastasios Koulaouzidis
7   Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh, UK
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Abstract

Background and study aims When capsule endoscopy (CE) detects a small bowel (SB) target lesion that may be manageable with enteroscopy, the selection of the insertion route is critical. Time- and progression-based CE indices have been proposed for localization of SB lesions. This systematic review analysed the role of CE transit indicators in choosing the insertion route for double-balloon enteroscopy (DBE).

Methods A comprehensive literature search identified papers assessing the role of CE on the choice of the route selection for DBE. Data on CE, criteria for route selection, and DBE success parameters were retrieved and analyzed according to the PRISMA statement. Risk of bias was assessed through the STROBE assessment. The primary outcome evaluated was DBE success rate in reaching a SB lesion, measured as the ratio of positive initial DBE to the number of total DBE.

Results Seven studies including 262 CEs requiring subsequent DBE were selected. Six studies used time-based indices and one used the PillCam Progress indicator. SB lesions were identified and insertion route was selected according to a specific cut-off, using fixed landmarks for defining SB transit except for one study in which the mouth-cecum transit was considered. DBE success rate was high in all studies, ranging from 78.3 % to 100 %. Six of seven studies were high quality.

Conclusions The precise localization of SB lesions remains an open issue, and larger studies are required to determine the most accurate index for selecting the DBE insertion route. In the future, 3 D localization technologies and tracking systems will be essential to accomplish this tricky task.

Supplementary material



Publikationsverlauf

Eingereicht: 11. August 2020

Angenommen: 19. Oktober 2020

Artikel online veröffentlicht:
25. Januar 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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