Double-balloon enteroscopy for retrieving retained small-bowel video capsule endoscopes: a systematic review

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Devices

Background:

• Capsule retention is a common complication of video capsule endoscopy.
• Double-balloon enteroscopy (DBE) is increasingly used for capsule retrieval.
• Limited evidence exists on DBE's success rate, influencing factors, and clinical outcomes for capsule retrieval.

Purpose of the Study:

• To systematically review and pool data on the success rate of double-balloon enteroscopy-assisted capsule endoscope retrieval.
• To identify factors associated with successful capsule retrieval using DBE.
• To evaluate clinical outcomes, including endoscopic balloon dilation and surgery rates, following DBE-assisted retrieval.

Main Methods:

• A systematic review of studies published before January 2019 was conducted.
• Data on successful retrieval rates, associated factors, endoscopic balloon dilation, and clinical outcomes were extracted and pooled.
• Statistical analysis was performed to determine pooled success rates and identify significant associations.

Main Results:

• Twelve studies comprising 150 cases of capsule retrieval by DBE were included.
• The pooled successful retrieval rate was 86.5%.
• Anterograde approach, jejunal retention, and malignant strictures were associated with higher success rates. Endoscopic balloon dilation was performed in 38.8% of cases with benign strictures. Surgery rates were significantly lower in successful retrieval cases (7.2% vs. 38.5%).

Conclusions:

• Double-balloon enteroscopy is a feasible and safe method for retrieving retained video capsule endoscopes.
• DBE can decrease the need for surgery in patients with benign strictures.
• DBE can facilitate subsequent surgery in patients with malignant strictures.