Retention associated with video capsule endoscopy: systematic review and meta-analysis

Area of Science:

• Gastroenterology
• Medical Devices
• Diagnostic Imaging

Background:

• Video capsule endoscopy (VCE) is a key tool for small-bowel examination.
• Capsule retention is a significant clinical concern, impacting diagnostic yield and patient safety.

Purpose of the Study:

• To systematically review and meta-analyze VCE retention rates across different clinical indications.
• To identify factors influencing capsule retention, particularly in inflammatory bowel disease (IBD).

Main Methods:

• A systematic review of PubMed and SCOPUS databases (1995-2015) was conducted.
• Studies with >=10 patients reporting VCE retention rates by indication were included.
• Pooled prevalence rates and 95% confidence intervals (CIs) were calculated using Comprehensive Meta-Analysis software.

Main Results:

• Overall VCE retention was 2.1% for small-bowel bleeding, 3.6% for suspected IBD, and 8.2% for established IBD.
• Retention rates for abdominal pain/diarrhea were 2.2%.
• Small-bowel strictures were the most common cause of retention; pre-screening with patency capsule/CT enterography reduced IBD retention rates to 2.7%.

Conclusions:

• VCE retention is generally low but higher in patients with IBD.
• Small-bowel strictures are a primary cause of retention.
• Pre-procedural patency assessment effectively minimizes retention risk in IBD patients.