Background: Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy (VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities in a large cohort of SSBB patients in a European tertiary center. Methods: We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or DBE from March 2001 to July 2020. Demographic/clinical parameters, anticoagulant therapies, technical characteristics and adverse events were collected, as well as diagnostic yield (DY), VCE–DBE concordance, hemoglobin (Hb) values before and after DBE, and complications. Results: 807 VCEs and 407 DBEs were performed in 751 patients. The DY was significantly higher in DBE compared with VCE (68.8% vs 57.7%), with the highest (75%) yield for overt active SB bleeding. The agreement between VCE and DBE was generally suboptimal (k = 0.059). This improved in cases where both procedures were done within 1–5 days of the other (k = 0.323). Post-procedural Hb values were significantly higher. In patients treated with direct oral anticoagulants (DOACs), there were no differences in DY, complications or Hb values compared with non-DOAC patients. Conclusion: VCE and DBE play a pivotal role in the diagnostic and therapeutic approach to SSBB, having a high clinical impact even in patients treated with DOACs.

Clinical impact of videocapsule and double balloon enteroscopy on small bowel bleeding: results from a large monocentric cohort in the last 19 years / L. Elli, L. Scaramella, G.E. Tontini, M. Topa, D. Conte, R. Sidhu, E. Rondonotti, R. Penagini, M. Vecchi. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - (2021), pp. 1-7. [Epub ahead of print] [10.1016/j.dld.2021.07.014]

Clinical impact of videocapsule and double balloon enteroscopy on small bowel bleeding: results from a large monocentric cohort in the last 19 years

L. Scaramella
Secondo
;
G.E. Tontini;M. Topa;D. Conte;E. Rondonotti;R. Penagini
Penultimo
;
M. Vecchi
Ultimo
2021

Abstract

Background: Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy (VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities in a large cohort of SSBB patients in a European tertiary center. Methods: We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or DBE from March 2001 to July 2020. Demographic/clinical parameters, anticoagulant therapies, technical characteristics and adverse events were collected, as well as diagnostic yield (DY), VCE–DBE concordance, hemoglobin (Hb) values before and after DBE, and complications. Results: 807 VCEs and 407 DBEs were performed in 751 patients. The DY was significantly higher in DBE compared with VCE (68.8% vs 57.7%), with the highest (75%) yield for overt active SB bleeding. The agreement between VCE and DBE was generally suboptimal (k = 0.059). This improved in cases where both procedures were done within 1–5 days of the other (k = 0.323). Post-procedural Hb values were significantly higher. In patients treated with direct oral anticoagulants (DOACs), there were no differences in DY, complications or Hb values compared with non-DOAC patients. Conclusion: VCE and DBE play a pivotal role in the diagnostic and therapeutic approach to SSBB, having a high clinical impact even in patients treated with DOACs.
Capsule endoscopy; Double balloon enteroscopy; Enteroscopy; Small bowel bleeding
Settore MED/12 - Gastroenterologia
7-ago-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/863655
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