These recommendations on video capsule endoscopy, an emerging technology with an impact on the practice of endoscopy, were developed by the European Society of Gastrointestinal Endoscopy (ESGE) Guidelines Committee.
The first draft of each section was prepared by one or two members of the writing team, who were selected as experts on the content of that section on the basis of their published work. They used evidence-based methodology, performing MEDLINE and PubMed literature searches to identify relevant clinical studies. Abstracts from scientific meetings were included only if there was no published full paper on a particular topic. If there was disagreement, the first author of the Guideline made the final decision. Recommendations were graded according to the strength of the supporting evidence ([Table 1 ]) [1 ]. The draft guideline was critically reviewed by all authors and submitted to the ESGE councillors for their critical review before approval of the final document.
The ESGE Guidelines Committee acknowledges that this document is based on a critical review of the data available at the time of preparation and that further studies may be needed to clarify some aspects. Moreover, this Guideline may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice.
This document should be regarded as supplying recommendations only to gastroenterologists in providing care to their patients. It is not a set of rules and should not be construed as establishing a legal standard of care, or as encouraging, advocating, requiring, or discouraging any particular treatment. These recommendations must be interpreted according to the clinician’s knowledge, expertise, and clinical judgment in the management of individual patients and, if necessary, a course of action that varies from recommendations must be undertaken.
References
1 Phillips B, Ball C, Sackett D. et al .Oxford Centre for Evidence-Based Medicine. Levels of evidence. May 2001 Accessed 28 February 2009: http://www.cebm.net/levels_of_evidence.asp
2
Eliakim R, Yassin K, Shlomi I. et al .
A novel diagnostic tool for detecting oesophageal pathology: the PillCam oesophageal video capsule.
Aliment Pharmacol Ther.
2004;
20
1083-1089
3
Eliakim R, Fireman Z, Gralnek I M. et al .
Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study.
Endoscopy.
2006;
38
963-970
4
Rey J F, Ladas S, Alhassani A, Kuznetsov K. ESGE Guidelines Committee .
Video capsule endoscopy: update to guidelines (May 2006).
Endoscopy.
2006;
38
1047-1053
5
Liao Z, Li Z S, Xu C.
Reduction of capture rate in the stomach increases the complete examination rate of capsule endoscopy: a prospective randomized controlled trial.
Gastrointest Endosc.
2009;
69
418-425
6
Rokkas T, Papaxoinis K, Triantafyllou K. et al .
Does purgative preparation increase the diagnostic yield of small bowel video capsule endoscopy? A meta-analysis.
Am J Gastroenterol.
2009;
104
219-227
7
Niv Y.
Efficiency of bowel preparation for capsule endoscopy examination: a meta-analysis.
World J Gastroenterol.
2008;
14
1313-1317
8
Marmo R, Spada C, Rotondano G. et al .
Efficacy of small bowel preparation to improve capsule endoscopy outcomes: a systematic review.
Endoscopy.
2008;
40 Suppl 1
A309
9
Apostolopoulos P, Liatsos C, Gralnek I M. et al .
Evaluation of capsule endoscopy in active, mild-to-moderate, overt GI bleeding.
Gastrointest Endosc.
2007;
66
1174-1181
10
Lai L H, Wong G I, Chow D K. et al .
Long term follow-up of patients with obscure gastrointestinal bleeding after negative capsule endoscopy.
Am J Gastroenterol.
2006;
101
1224-1228
11
Carey E J, Leighton J A, Heigh R I. et al .
A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding.
Am J Gastroenterol.
2007;
102
89-95
12
Triester S L, Leighton J A, Leontiadis G I. et al .
A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding.
Am J Gastroenterol.
2005;
100
2407-2418
13
de Leusse A, Vahedi K, Edery J. et al .
Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding?.
Gastroenterology.
2007;
132
855-862
14
Saperas E, Dot J, Videla S. et al .
Capsule endoscopy versus computed tomographic or standard angiography for the diagnosis of obscure gastrointestinal bleeding.
Am J Gastroenterol.
2007;
102
731-737
15
Hartmann D, Schmidt H, Bolz G. et al .
A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding.
Gastrointest Endosc.
2005;
61
826-832
16
Mehdizadeh S, Ross A, Gerson L. et al .
What is the learning curve associated with double balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers.
Gastrointest Endosc.
2006;
64
740-750
17
Hadithi M, Heine G D, Jacobs M A. et al .
A prospective study comparing video capsule endoscopy with double balloon enteroscopy in patients with obscure gastrointestinal bleeding.
Am J Gastroenterol.
2006;
101
52-57
18
Nakamura M, Niwa Y, Ohmiya N. et al .
Preliminary comparison of capsule endoscopy and double-balloon enteroscopy in patients with suspected small-bowel bleeding.
Endoscopy.
2006;
38
59-66
19
Kamalaporn P, Cho S, Basset N. et al .
Double-balloon enteroscopy following capsule endoscopy in the management of obscure gastrointestinal bleeding: outcome of a combined approach.
Can J Gastroenterol.
2008;
22
491-495
20
Kameda N, Higuchi K, Shiba M. et al .
A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding.
J Gastroenterol.
2008;
43
434-440
21
Marmo R, Rotondano G, Rondonotti E. et al .
Capsule enteroscopy vs other diagnostic procedures in diagnosing obscure gastrointestinal bleeding: a cost-effectiveness study.
Eur J Gastroenterol Hepatol.
2007;
19
535-542
22
Apostolopoulos P, Liatsos C, Gralnek I M. et al .
The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract.
Endoscopy.
2006;
38
1127-1132
23
Triester S L, Leighton J A, Leontiadis G I. et al .
A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn's disease.
Am J Gastroenterol.
2006;
101
954-964
24
Cheifetz A S, Korenbluth A A, Legnani P. et al .
The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease.
Am J Gastroenterol.
2006;
101
2218-2222
25
Banerjee R, Bhargav P, Reddy P. et al .
Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical study.
J Gastroenterol Hepatol.
2007;
22
2060-2063
26
Graham D Y, Opekun A R, Willingham F F. et al .
Visible small-intestinal mucosal injury in chronic NSAID users.
Clin Gastroenterol Hepatol.
2005;
3
55-59
27
Hopper A D, Sidhu R, Hurlstone D P. et al .
Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease?.
Dig Liv Dis.
2007;
39
140-145
, . Epub 2006 Sep 11
28
Rondonotti E, Spada C, Cave D. et al .
Video capsule enteroscopy in the diagnosis of celiac disease: a multicenter study.
Am J Gastroenterol.
2007;
102
1624-1631
29
Murray J A, Rubio-Tapia A, VanDyke C T. et al .
Mucosal atrophy in celiac disease: extent of involvement, correlation with clinical presentation and response to treatment.
Clin Gastroenterol Hepatol.
2008;
6
186-193
30
Culliford A, Daly J, Diamond B. et al .
The value of wireless capsule endoscopy in patients with complicated celiac disease.
Gastrointest Endosc.
2005;
62
55-61
31
Daum S, Wahnschaffe U, Glasenapp R. et al .
Capsule endoscopy in refractory celiac disease.
Endoscopy.
2007;
39
455-458
32
Mata A, Llach J, Castells A. et al .
A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes.
Gastrointest Endosc.
2005;
61
721-725
33
Caspari R, von Falkenhausen M, Krautmacher C. et al .
Comparison of capsule endoscopy and magnetic resonance imaging for the detection of polyps of the small intestine in patients with familial adenomatous polyposis or with Peutz–Jeghers' syndrome.
Endoscopy.
2004;
36
1054-1059
34
Burke C A, Santisi J, Church J. et al .
The utility of capsule endoscopy small bowel surveillance in patients with polyposis.
Am J Gastroenterol.
2005;
100
1498-1502
35
Schulmann K, Hollerbach S, Kraus K. et al .
Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes.
Am J Gastroenterol.
2005;
100
27-37
36
Iaquinto G, Fornasarig M, Quaia M. et al .
Capsule endoscopy is useful and safe for small-bowel surveillance in familial adenomatous polyposis.
Gastrointest Endosc.
2008;
67
61-67
37
Clarke J O, Giday S A, Magno P. et al .
How good is capsule endoscopy for detection of periampullary lesions? Results of a tertiary-referral center.
Gastrointest Endosc.
2008;
68
267-272
38
Wong R F, Tuteja A K, Haslem D S. et al .
Video capsule endoscopy compared with standard endoscopy for the evaluation of small-bowel polyps in persons with familial adenomatous polyposis (with video).
Gastrointest Endosc.
2006;
64
530-537
39
Urbain D, De Looze D, Demedts I. et al .
Video capsule endoscopy in small-bowel malignancy: a multicenter Belgian study.
Endoscopy.
2006;
38
408-411
40
Rondonotti E, Pennazio M, Toth E. et al .
Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study.
Endoscopy.
2008;
40
488-495
41
Sharma P, Wani S, Rastogi A. et al .
The diagnostic accuracy of esophageal capsule endoscopy in patients with gastroesophageal reflux disease and Barrett’s esophagus: A blinded prospective study.
Am J Gastroenterol.
2007;
102
1-8
42
Galmiche J P, Sacher-Huvelin S, Coron E. et al .
Screening for esophagitis and Barrett’s esophagus with wireless esophageal capsule endoscopy. A multicenter prospective trial in patients with reflux symptoms and/or dyspepsia.
Am J Gastroenterol.
2008;
103
538-45
43
Delvaux M, Papanikolaou I S, Fassler I. et al .
Esophageal capsule endoscopy in patients with suspected esophageal disease: double blinded comparison with esophagogastroduodenoscopy and assessment of interobserver variability.
Endoscopy.
2008;
40
16-22
44
Bang S, Park J Y, Jeong S. et al .
First clinical trial of the ”MiRo” capsule endoscope by using a novel transmission technology: electric-field propagation.
Gastrointest Endosc.
2009;
69
253-259
45
Cave D R, Fleischer D E, Leighton J A. et al .
A multicenter randomized comparison of the Endocapsule and the Pillcam SB.
Gastrointest Endosc.
2008;
68
487-494
46
Hartmann D, Eickhoff A, Damian U. et al .
Diagnosis of small-bowel pathology using paired capsule endoscopy with two different devices: a randomized study.
Endoscopy.
2007;
39
1041-1045
47
Gheorghe C, Iacob R, Bancila I.
Olympus capsule endoscopy for small bowel examination.
J Gastrointest Liver Dis.
2007;
16
309-313
48
Li C Y, Zhang B L, Chen C X. et al .
OMOM capsule endoscopy in diagnosis of small bowel disease.
J Zhejiang Univ Sci B.
2008;
9
857-862
49
Herrerias J M, Leighton J A, Costamagna G. et al .
Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy.
Gastrointest Endosc.
2008;
67
902-909
50
Postgate A J, Burling D, Gupta A. et al .
Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: a 3-year technical review.
Dig Dis Sci.
2008;
53
2732-2738
51
Shiotani A, Opekun A R, Graham D Y.
Visualization of the small intestine using capsule endoscopy in human subjects.
Dig Dis Sci.
2007;
52
1019-1025
52
Triantafyllou K, Kalli T, Ladas S D.
Small bowel purge after the entrance of the capsule in the duodenum results to better quality of bowel preparation for video-capsule endoscopy. Prospective, randomized, double-blind, placebo-controlled, real time viewer assisted study.
Gastrointest Endosc.
2008;
134 (Suppl 1)
A339
53
Ge Z Z, Chen H Y, Gao Y J. et al .
The role of simeticone in small-bowel preparation for capsule endoscopy.
Endoscopy.
2006;
38
836-840
54
Mergener K, Ponchon T, Gralnek I. et al .
Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/2007.
Endoscopy.
2007;
39
895-909
55
Ben-Soussan E, Savoye G, Antonietti M. et al .
Factors that affect gastric passage of video capsule.
Gastrointest Endosc.
2005;
62
785-790
56
Westerhof J, Weersma R K, Koornstra J J.
Risk factors for incomplete small-bowel capsule endoscopy.
Gastrointest Endosc.
2009;
69
74-80
57
Triantafyllou K, Kalantzis C, Papadopoulos A A. et al .
Video-capsule endoscopy gastric and small bowel transit time and completeness of the examination in patients with diabetes mellitus.
Dig Liv Dis.
2007;
39
575-580
58
Papadopoulos A A, Triantafyllou K, Kalantzis C. et al .
Effects of ageing on small bowel video capsule endoscopy examinations.
Am J Gastroenterol.
2008;
103
1-7
59
Lai L H, Wong G LH, Lau J YW.
Initial experience of real-time capsule endoscopy in monitoring progress of the video capsule through the upper GI tract.
Gastrointest Endosc.
2007;
66
1211-1214
60
Solem C A, Loftus Jr E V, Fletcher J G. et al .
Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial.
Gastrointest Endosc.
2008;
68
255-266
61
Pons B eltran, Nos P, Bastida G. et al .
Evaluation of postsurgical recurrence in Crohn’s disease: a new indication for capsule endoscopy.
Gastrointest Endosc.
2007;
66
533-540
62
Mehdizadeh S, Chen G, Enayati P J. et al .
Diagnostic yield of capsule endoscopy in ulcerative colitis and inflammatory bowel disease of unspecific type.
Endoscopy.
2008;
40
30-35
63
Gal E, Geller A, Fraser G. et al .
Assessment and validation of the new capsule endoscopy Crohn’s disease activity index.
Dig Dis Sci.
2008;
53
1933-1937
64
Efthymiou A, Viazis N, Mantzaris G. et al .
Does clinical response correlate with mucosal healing in patients with Crohn’s disease of the small bowel? A prospective, case-sensitive study using wireless capsule endoscopy.
Inflamm Bowel Dis.
2008;
14
1542-1547
65
Girelli C M, Porta P, Malacrida V. et al .
Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn’s disease.
Dig Liv Dis.
2007;
39
148-154
66
Matsumoto T, Esaki M, Moriyama T. et al .
Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis.
Endoscopy.
2005;
37
827-832
67
Cobrin G M, Pittman R H, Lewis B S.
Increased diagnostic yield of small bowel tumors with capsule endoscopy.
Cancer.
2006;
107
22-27
68
Bailey A A, Debinski H S, Appleyard M N. et al .
Diagnosis and outcome of small bowel tumors found by capsule endoscopy: a three-center Australian experience.
Am J Gastroenterol.
2006;
101
2237-2243
69
Schwartz G D, Barkin J S.
Small-bowel tumors detected by wireless capsule endoscopy.
Dig Dis Sci.
2007;
52
1026-1030
70
Estevez E, Gonzalez-Conde B, Vazquez-Iglesias J L. et al .
Incidence of tumoral pathology according to study using capsule endoscopy for patients with obscure gastrointestinal bleeding.
Surg Endosc.
2007;
21
1776-1780
71
Spada C, Riccioni M E, Familiari P. et al .
Video capsule endoscopy in small-bowel tumours: a single centre experience.
Scand J Gastroenterol.
2008;
43
497-505
72
Prakoso E, Selby W S.
Capsule endoscopy in patients with malignant melanoma.
Am J Gastroenterol.
2007;
102
1204-1208
73
Hogan R B, Ahmad N, Hogan 3rd R B. et al .
Video capsule endoscopy detection of jejunal carcinoid in life-threatening hemorrhage, first trimester pregnancy.
Gastrointest Endosc.
2007;
66
205-207
74
Wax J R, Pinette M G, Cartin A. et al .
Cavernous transformation of the portal vein complicating pregnancy.
Obstet Gynecol.
2006;
108
782-784
75
Bandorski D, Irnich W, Brück M. et al .
Capsule endoscopy and cardiac pacemakers: investigation for possible interference.
Endoscopy.
2008;
40
36-39
76
Leighton J A, Srivathsan K, Carey E J. et al .
Safety of wireless capsule endoscopy in patients with implantable cardiac defibrillators.
Am J Gastroenterol.
2005;
100
1728-1731
77
Gralnek I M, Adler S N, Yassin K. et al .
Detecting esophageal disease with second-generation capsule endoscopy: initial evaluation of the PillCam ESO 2.
Endoscopy.
2008;
40
275-279
78
Gralnek I M, Rabinovitz R, Afik D. et al .
A simplified ingestion procedure for esophageal capsule endoscopy: initial evaluation in healthy volunteers.
Endoscopy.
2006;
38
913-918
79
Koslowsky B, Jacob H, Eliakim R. et al .
PillCam ESO in esophageal studies: improved diagnostic yield of 14 frames per second (fps) compared with 4 fps.
Endoscopy.
2006;
38
27-30
80
Lin O S, Schembre D B, Mergener K. et al .
Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux.
Gastrointest Endosc.
2007;
65
577-583
81
de Franchis R, Eisen G M, Laine L. et al .
Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension.
Hepatology.
2008;
47
1595-1603
82
Spiegel B M, Esrailian E, Eisen G.
The budget impact of endoscopic screening for esophageal varices in cirrhosis.
Gastrointest Endosc.
2007;
66
679-692
83
Stipho S, Das A, Sharma V K. et al .
Cost effectiveness of string capsule endoscopy for screening and surveillance of esophageal varices.
Gastroenterology.
2007;
132
A557
84
Schoofs N, Deviere J, Van Gossum A.
PillCam Colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study.
Endoscopy.
2006;
38
971-977
85
Van Gossum A, Munoz-Navas M, Fernandez-Urien I. et al .
Capsule endoscopy versus colonoscopy for the detection of polyps and cancer.
N Engl J Med 2009.
16;
361
264-270
86
Rokkas T, Papaxoinis K, Triantafyllou K, Ladas S D.
A meta-analysis evaluating the accuracy of colon capsule endoscopy in detecting colon polyps.
Gastrointest Endosc.
2010;
(in press)
87
Triantafyllou K, Tsimbouris P, Kalantzis C. et al .
PillCam colon capsule endoscopy does not always complement incomplete colonoscopy.
Gastrointest Endosc.
2009;
69
572-576
S. D. LadasMD
First Department of Internal Medicine-Propaedeutic Laiko General Hospital of Athens Medical School, Athens University
Athens, Greece
Fax: +30-210-7225882
Email: sdladas@otenet.gr