CLINICAL IMPACT OF VIDEOCAPSULE AND DOUBLE BALLOON ENTEROSCOPY ON SMALL BOWEL BLEEDING: RESULTS FROM A LARGE MONOCENTRIC COHORT IN THE LAST 19 YEARS

Luca Elli, Lucia Scaramella, Gian Eugenio Tontini, Matilde Topa, Dario Conte, Reena Sidhu, Emanuele Rondonotti, Roberto Penagini, Maurizio Vecchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy (VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities in a large cohort of SSBB patients in a European tertiary center. Methods: We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or DBE from March 2001 to July 2020. Demographic/clinical parameters, anticoagulant therapies, technical characteristics and adverse events were collected, as well as diagnostic yield (DY), VCE–DBE concordance, hemoglobin (Hb) values before and after DBE, and complications. Results: 807 VCEs and 407 DBEs were performed in 751 patients. The DY was significantly higher in DBE compared with VCE (68.8% vs 57.7%), with the highest (75%) yield for overt active SB bleeding. The agreement between VCE and DBE was generally suboptimal (k = 0.059). This improved in cases where both procedures were done within 1–5 days of the other (k = 0.323). Post-procedural Hb values were significantly higher. In patients treated with direct oral anticoagulants (DOACs), there were no differences in DY, complications or Hb values compared with non-DOAC patients. Conclusion: VCE and DBE play a pivotal role in the diagnostic and therapeutic approach to SSBB, having a high clinical impact even in patients treated with DOACs.

Original languageEnglish
Pages (from-to)251-257
JournalDigestive and Liver Disease
Volume54
Issue number2
DOIs
Publication statusPublished - 2022

Keywords

  • Capsule endoscopy
  • Double balloon enteroscopy
  • Enteroscopy
  • Small bowel bleeding

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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