Long-Term Follow-Up of Patients with Endoscopic Treatment of Sporadic Adenomas of the Papilla of Vater

Saurin, Jean Christophe; Chavaillon, Annick; Napoléon, Bertrand; Descos, F.; Bory, R; Berger, Felix; Ponchon, Thierry

doi:10.1055/s-2003-38767

Cited by 165 publications

(43 citation statements)

References 14 publications

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“…In 58/283 patients (20%), however, no method succeeded in locating the source of OGIB. Our results support the findings of others who showed that CE could also identify pathologies that had been missed at gastroscopy or colonoscopy [10,11,12,13,14,15,34,35,36,37,38,39]. …”

Section: Discussionsupporting

confidence: 92%

“…Our clinical data show a high diagnostic yield (72%) of CE compared to recently published studies that showed the diagnostic yield to vary from 32 to 76% [10,11,12, 15, 35, 39]. This difference may be explained, at least in part, by the relatively small size of the other studies (approximately 20–60 patients in each).…”

Section: Discussioncontrasting

confidence: 56%

“…It was reported by many investigators to have a greater yield than push-enteroscopy for investigating OGIB [10,11,12,35,36,37,38,39]. In addition, although the reported yield for push-enteroscopy in OGIB is 38–75%, the true yield is lower because many of these findings (28–75%) are within reach of an endoscope [10,11,12,13,14,15]. These resultsare supported by other studies [38, 39].…”

Section: Discussionmentioning

confidence: 99%

“…Recent data from smaller studies have shown that capsule endoscopy (CE) has high diagnostic yield in OGIB [10,11,12,13,14,15]. The purpose of the current study is to provide an overview of the role of CE by evaluating an unprecedented large number of patients with OGIB as the source of their IDA.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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Objectives:Chronic occult blood loss from the gastrointestinal tract is a recognized major cause of iron-deficiency anemia. After conventional investigation of the upper and lower parts of the gastrointestinal tract, the source of bleeding remains unidentified in ~10% of these patients. We evaluated the diagnostic yield of capsule endoscopy from patients enrolled in clinical studies due to persistent or recurrent iron-deficiency anemia. Methods: In this large cohort study, patients with obscure gastrointestinal bleeding were identified in a company-sponsored clinical study (Given Imaging, Ltd.) database which contains data from >50 clinical studies. Information on suitable patients was derived from 31 of them. Each subject swallowed an M2A^® Given Capsule containing a miniature video camera, batteries, a transmitter and an antenna. Recording time was ~8 h. The capsule was excreted naturally in the patient’s bowel movement, and the data it transmitted were retrieved and interpreted the next day. Results: 293 patients were studied (135 males, 46.1%, mean age 59.4 ± 16.8 years) whose mean number of bleeding episodes was 4.3 ± 5.5 and mean hemoglobin level was 9.8 ± 2.4 g/dl. The average number of diagnostic procedures per patient prior to the capsule endoscopy study was 5.59. Capsule endoscopy detected definitive findings in 213/293 patients (72%) and findings missed by other diagnostic procedures in 22/293 patients (8%). Neither capsule endoscopy nor the other diagnostic procedures yielded diagnoses in 58/293 patients (20%). Conclusions: Capsule endoscopy has a high diagnostic yield in evaluating patients with obscure gastrointestinal bleeding.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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“…Currently CE is being used to evaluate GI bleeding of obscure origin, small-bowel pathology such as polyposis syndromes, inflammatory and infiltrative small-bowel disorders [1,2,3,4]. CE has been compared with push enteroscopy in the evaluation of small-bowel lesions and it has been found to be a better modality [5,6,7,8]. The superior performance of CE is probably due to the fact that it can deliver detailed images of the mucosa because of its closer proximity to the mucosal wall, thereby distinguishing smaller lesions, including those between the folds.…”

Section: Introductionmentioning

confidence: 99%

Capsule Endoscopy of the Upper Gastrointestinal Tract – The Need for a Second Endoscopy

Peter

Heuss²,

Beglinger³

et al. 2005

Digestion

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Background and Aims: Capsule endoscopy (CE) has been recognised as an important investigational tool in the diagnosis of gastrointestinal disease. Studies have shown that CE can identify lesions in the upper gastrointestinal tract as well as in the small intestine. However, contrary to conventional oesophagogastroscopy results, the role of CE findings in the diagnostic algorithm of disorders such as gastrointestinal bleeding has not been well understood. We evaluated the frequency of lesions identified in the oesophagus and the stomach as well as their significance. Methods: We retrospectively evaluated patients who had undergone video CE over the last 2 years at our institution. Indication and findings in the oesophagus and the stomach were analysed and compared to previous oesophagogastroscopy findings. Patients in whom lesions were identified were followed up retrospectively for the significance of these findings. Results: 95 patients were included in the analysis (47 males, 48 females, mean ± SD age of 54.62 ± 19.2 years). The commonest indication for CE was gastrointestinal bleeding (45%), the second commonest anaemia (28%). CE identified significant lesions in the stomach of 11/95 (11.57%) patients. These lesions had been overlooked in 9/95 (9%) of patients by conventional oesophagogastroscopy prior to CE examination (p value < 0.05). Eight of 95 (8%) patients had oesophageal abnormalities detected by CE. The diagnosis changed the treatment of 8/11 (82%) patients with significant lesions. Conclusions: CE has an undefined role in evaluating upper gastrointestinal lesions. Significant lesions missed at oesophagogastroscopy were identified during CE examination. This study underpins the importance of a second conventional endoscopy in the diagnostic algorithm.

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