Clinical feasibility of panintestinal (or panenteric) capsule endoscopy: a systematic review

Abstract

In recent years, panintestinal capsule endoscopy (PCE) with double-headed capsules has been used to perform complete, single-sitting exploration of both small bowel and colon in different clinical conditions. Double-headed capsules for colonic examination (CCE) have been exploited first in this setting, followed by newer generations of capsules (i.e. PillCam Crohn, PCC) specifically engineered for this purpose. The aim of this study was to evaluate the feasibility of PCE in the form of a systematic review. We performed a comprehensive literature search to identify papers in which CE was specifically used for a PCE of the gastrointestinal tract. Data on CE, bowel preparation regimen, rate of cleanliness and completeness, and data on transit times were analyzed. The primary outcome was to assess the feasibility of a whole-gut exploration with CE. Sixteen (n = 16) studies including 915 CE procedures with CCE1 (n = 134), CCE2 (n = 357) and PCC (n = 424) were included. 13/16 studies were performed in the setting of Crohn’s disease. Cleanliness and completeness rates were acceptable in all studies, ranging from 63.9% and 68.6% to 100%, respectively. In conclusion, PCE is a feasible technique, although further structured studies are needed to explore its full potential.

Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

“…Studies have evaluated the diagnostic performances of PCE using CCE-2 or PCC in patients with CD [ 85 ]. PCE was successful in CD patients who refused colonoscopy or underwent an incomplete colonoscopy [ 86 ].…”

“…The sensitivity and specificity of PCE for small bowel lesions (84.2–90.0% and 63.4–87.5%, respectively) and large bowel lesions (80.0–90.0% and 72.2–84.7%, respectively) were comparable to the results of double balloon enteroscopy in patients with CD [ 95 ]. Acceptable bowel preparation rates for PCE were reported to range from 63.9% to 100% [ 85 ]. At present, the applications and values of PCE for CD remain unclear yet due to lack of large scale and/or randomized controlled trials.…”

An Overview of the Evolution of Capsule Endoscopy Research—Text-Mining Analysis and Publication Trends

“…Manufacturers are steadily increasing technological specifications and diversifying CE models. Although small bowel (SB) CE remains the workhorse of CE [ 4 ], colon CE appears to get a firm grip in current years, and other models for the examination of the stomach or the stomach and the SB together, as well as those that provide panenteric visualization in one setting [ 5 ], have emerged.…”

Light flickering through a narrow window opening in capsule panendoscopy

“…Both colon capsules and the newer PillCam Crohn’s capsule have been used for panendoscopy in several settings. Although with mixed results – mainly regarding adequate colonic cleansing and completion rates 2 , the use of camera capsules for the assessment of the whole gut is here to stay. However, as most roses come with thorns, some crucial issues need to be addressed:…”