A Preliminary Comparison of Capsule Endoscopy and Double-Balloon Enteroscopy in Patients with Suspected Small Bowel Bleeding

Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding: An updated meta‐analysis

“…Subgroup analysis of the diagnostic yield of DBE performed after a previously positive CE was calculated only from those studies that provided sufficient data (Table 2). Among these studies, 14–17,19,20,22 the pooled diagnostic yield was 75.0% (95% CI 60.1–90.0) and the odds ratio for the yield of DBE performed after a previously positive CE compared with that of DBE performed in all patients was 1.79 (95% CI 1.09–2.96; P = 0.02) (Fig. 3).…”

“…A flow diagram illustrating the study selection process is shown in Figure 1. One hundred forty‐seven unique references were initially identified by the search, of which 10 studies met all inclusion criteria 14–23 . In fact, 14 studies met the criteria for inclusion in the systematic review, but four of these papers 24–27 were ultimately excluded from the meta‐analysis because in these studies DBE was only performed in patients with a previously positive CE, which represents a selected patient population compared with patients with OGIB undergoing both CE and DBE.…”

“…In nearly all cases CE preceded DBE, except for one study 18 in which patients underwent DBE prior to CE, and a second study 21 in which CE was not uniformly performed before or after DBE. With only two exceptions, 14,18 all studies examined a mixed population of OGIB patients, reporting combined results for both those with overt and occult manifestations of GI bleeding.…”

“…The mean score was 16.1 (range 10–20; out of a possible score of 21). Five studies were considered to be of excellent quality, 14,17,19,22,23 four of good quality, 15,16,18,21 and one study as moderate quality 20 . The overall interobserver agreement was 86.2% giving a kappa of 0.62, indicating substantial agreement.…”

“…Since there is a significantly increased diagnostic yield when DBE is performed after a positive CE, having the results from capsule endoscopy available may create detection bias in the yield of DBE. Only the studies by Nakamura et al 14 . and Kameda et al 16 .…”