Safety and efficacy of wireless capsule endoscopy in patients with surgically altered upper gastrointestinal anatomy

Abstract

Background: Wireless capsule endoscopy (WCE) is an effective, minimally invasive tool used for evaluation of the small intestine. To date, there are no studies evaluating the diagnostic yield of WCE in patients with surgically altered upper gastrointestinal anatomy. Aim: To evaluate the diagnostic yield, technical success and safety of WCE in patients with surgically altered upper gastrointestinal anatomy. Methods: Retrospective chart review of all patients with surgically altered upper GI anatomy who underwent WCE between 2006 and 2016 at the Medical University of South Carolina. Technical success, diagnostic yield, adverse events and therapeutic yield data was collected. Results: Thirty-one cases met inclusion criteria. Two were excluded as they did not undergo WCE due to failed patency capsule. The mean age was 58 (69% female). The capsule was ingested in 18 cases and endoscopically placed in 11. The most common surgical anatomy was Roux-en-Y gastric bypass (n = 13). Technical success, defined as the capsule reaching the cecum, was achieved in 89.7% of cases. The diagnostic yield was 44.8%, with the most common finding being angioectasia. No intra- or post-procedural adverse events were noted. Discussion: Capsule endoscopy in patients with surgically altered upper GI anatomy appears to show no elevated risk of adverse events and shows similar technical success and diagnostic yield as in patients with native anatomy. Keywords: Capsule endoscopy, Diagnosis, Digestive system surgical procedures, Diagnostic techniques, Gastric bypass