Clinical Practice Guideline for Enteroscopy

Yamamoto, Hironori; Ogata, Haruhiko; Matsumoto, Takayuki; Ohmiya, Naoki; Ohtsuka, Kazuo; Watanabe, Kenji; Yano, Tomonori; Matsui, Toshiyuki; Higuchi, Kazuhide; Nakamura, Tetsuya; Fujimoto, Kazuma

doi:10.1111/den.12883

Cited by 139 publications

(175 citation statements)

References 185 publications

(256 reference statements)

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“…Several medical societies in Western countries and Korea have released diagnostic algorithms for OGIB . The Japan Gastroenterological Endoscopy Society (JGES) released diagnostic algorithms for OGIB in 2017 . Most medical societies recommend that SBCE be the first‐line method for exploring the source of OGIB without obstructive symptoms.…”

Section: Indications For Sbcementioning

confidence: 99%

Capsule endoscopy for small‐intestinal disorders: Current status

Hosoe

Takabayashi

Ogata

et al. 2019

Digestive Endoscopy

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Small‐bowel capsule endoscopy (SBCE) is used widely because of its non‐invasive and patient‐friendly nature. SBCE can visualize entire small‐intestinal mucosa and facilitate detection of small‐intestinal abnormalities. In this review article, we focus on the current status of SBCE. Several platforms for SBCE are available worldwide. Third‐generation SBCE (PillCam® SB3) has a high‐resolution camera equipped with an adaptive frame rate system. Several software modes have been developed to reduce the reading time for capsule endoscopy and to minimize the possibility of missing lesions. The main complication of SBCE is capsule retention. Thus, the main contraindication for SBCE is known or suspected gastrointestinal obstruction unless intestinal patency is proven. Possible indications for SBCE are obscure gastrointestinal bleeding, Crohn's disease, small‐intestinal polyps and tumors, and celiac disease. Colon capsule endoscopy (CCE) can observe inflamed colonic mucosa non‐invasively, and allows for the continuous and non‐invasive observation of the entire intestinal tract (pan‐endoscopy). Recently, application of CCE as pan‐enteric endoscopy for inflammatory bowel diseases (including Crohn's disease) has been reported. In the near future, reading for CE will be assisted by artificial intelligence, and reading CE videos for long periods will not be required.

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Section: Indications For Sbcementioning

confidence: 99%

Capsule endoscopy for small‐intestinal disorders: Current status

Hosoe

Takabayashi

Ogata

et al. 2019

Digestive Endoscopy

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“…DBE or Meckel’s scintigraphy is recommended if there are no abnormal findings in CE and further workup is necessary in clinical practice guideline for enteroscopy by Japan Gastroenterological Endoscopy Society [28]. On the other hand, there are some reports that repeated CE was beneficial due to its high diagnostic yield.…”

Section: Management Of Negative Ce Findingsmentioning

confidence: 99%

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

et al. 2018

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Background: Obscure gastrointestinal bleeding (OGIB) is a common but embarrassing problem for gastroenterologists. Most bleeding lesions associated with OGIB are present in the small intestine and sometimes cannot be identified due to the difficulty associated with physical accessibility. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have enabled in the process of diagnosing and have evolved to become approaches to treating OGIB. Summary: CE is a minimally invasive procedure and has a high diagnostic yield in patients with OGIB. DBE offers additional advantage of biopsy collection for pathological diagnosis and therapeutic intervention, but it should be noted that it sometimes causes severe adverse events such as acute pancreatitis, intestinal bleeding, and intestinal perforation. CE should be performed early in the workup course of OGIB. Positive CE findings enhance the diagnostic yield of subsequent DBE, and the effective therapeutic intervention improves the clinical outcomes of OGIB patients. On the contrary, there are no clear guidelines for further investigation of patients with negative CE findings at the present. Although patients in stable general condition may only require follow-up, repeated CE is useful to detect positive findings in patients with evidence of sustained bleeding and progressing anemia. We have revealed that repeated CE has higher positive finding rate than DBE in OGIB patients with negative CE findings in a preliminary study. Key Messages: CE and DBE have complementary roles in the management of OGIB, and the precise timing and proper sequence may be important for the approach to treating OGIB.

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“…Some tumors that have not been detected by CE may be detected by other modalities [19]. For this reason, in the clinical guidelines for Japan, the combined use of CE and enhanced CT is recommended for screening of small bowel tumors [20,21]. In one case with a small intestinal tumor in this study, enhanced CT could not be performed because of renal dysfunction, which might have led to a delay in the diagnosis.…”

Section: Discussionmentioning

confidence: 86%

Long-Term Prognosis of Patients with Obscure Gastrointestinal Bleeding: A Retrospective Cohort Study

et al. 2019

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Aims: We evaluated the long-term prognosis of patients with obscure gastrointestinal bleeding (OGIB) who underwent capsule endoscopy (CE). Methods: In our hospital, 429 patients underwent CE between November 2007 and March 2012. Among them, 259 patients underwent CE as the first examination for OGIB and were then followed at 77 clinics and hospitals. The clinical characteristics were investigated, including age, gender, overt/occult bleeding, the use of antithrombotic drugs and NSAIDs, complications (liver cirrhosis and hemodialysis), and CE. We asked the medical institutions for their survival data as of August 2017 (> 5 years after CE). Results: The prognoses of 240 patients (92.6%) were analyzed. The average follow-up period was 55.7 (1–115) months. During the follow-up period, 57 patients (23.8%) died and the survival rates were 90.5% at 1 year, 81.7% at 3 years, and 74.7% at 5 years. Age 65 years or older and liver cirrhosis were predictive factors for a poor prognosis. Rebleeding occurred in 42 patients (17.9%) and small bowel cancer and gastrointestinal stromal tumor were found at 12 and 21 months after CE, respectively. Conclusions: Patients with OGIB showed a poor prognosis, especially those who were elderly or who had liver cirrhosis.

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Clinical Practice Guideline for Enteroscopy

Cited by 139 publications

References 185 publications

Capsule endoscopy for small‐intestinal disorders: Current status

Capsule endoscopy for small‐intestinal disorders: Current status

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

Long-Term Prognosis of Patients with Obscure Gastrointestinal Bleeding: A Retrospective Cohort Study

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