Diagnostic and therapeutic yields of early capsule endoscopy and device-assisted enteroscopy in the setting of overt GI bleeding: a systematic review with meta-analysis

Predicting the future: introducing business analytics to endoscopy units

“…Conversely, a slight negative trend in demand for deep enteroscopy was identified. Deep enteroscopy is also a relatively new procedure and although awareness of this procedure and its potential therapeutic capabilities are currently well known, its indications have been increasingly refined as scientific evidence of its efficacy and limitations accumulates [21][22][23][24], providing a possible explanation for the negative trend that was observed. Some seasonality in demand was observed for EGD, colonoscopy, and PEG.…”

Very High Yield of Urgent Small-Bowel Capsule Endoscopy for Ongoing Overt Suspected Small-Bowel Bleeding Irrespective of the Usual Predictive Factors

“…SBCE findings were classified according to standard practice [ 10 ] as lesions with high bleeding potential (P2) and those with uncertain or no bleeding potential (P1 and P0, respectively). Angioectasia, Dieulafoy’s lesion, arteriovenous malformation, varix, tumor, polyp, ulceration, diverticulum, or the presence of blood and/or blood clots in the lumen of the SB were classified as P2 lesions, as previously described [ 6 ]. The primary endpoints were the diagnostic and “non-conservative” therapeutic yields.…”

“…SBCE has a key role in the diagnosis of suspected small-bowel bleeding (SSBB); it is widely available and has a good safety profile. In addition, the early performance of SBCE has been reported to translate into better patient management [ 5 , 6 ]. Accordingly, the European Society of Gastrointestinal Endoscopy recommends performing SBCE as soon as possible after the bleeding episode, although a timespan of up to 14 days is recommended.…”

“…Accordingly, the European Society of Gastrointestinal Endoscopy recommends performing SBCE as soon as possible after the bleeding episode, although a timespan of up to 14 days is recommended. Even though the recent metanalyses advise an earlier approach, tendentiously within the first 48 hours [ 6 ], the optimal timepoint remains to be determined. The management of mid-GI bleeding may be challenging, as it relies on a sequence of endoscopic procedures that require time and resources.…”

Implementing precision medicine in endoscopy practice

“…A most recent meta‐analysis comparing diagnostic yields between early (within 14 days) and non‐early SBCE demonstrated that the odds for positive findings were higher with early SBCE, particularly during ongoing bleeding 72 . Early DAE performed within 3 days also offered higher diagnostic and therapeutic yields compared with non‐early DAE 72 . When bleeding appears to have stabilized at time of hospital presentation, particularly after 14 days of onset, 73 the diminishing values of SBCE or DAE should be carefully weighed against the cost and risk of procedure complications.…”