Predictive role of capsule endoscopy on the insertion route of double-balloon enteroscopy.
OBJECTIVE
Double-balloon enteroscopy (DBE) has been suggested to be more efficient if based on the results of screening video capsule endoscopy (VCE). We evaluated the utility of VCE for predicting the best insertion route of DBE for the evaluation and treatment of small-bowel lesions.


METHODS
Results of studies of patients with complete VCE examination of the small bowel and with findings confirmed by DBE are reported. A location index of lesions found on VCE was defined as the time from the pylorus to the lesion as a percentage of the time from the pylorus to the ileocecal valve. Based on our previous retrospective evaluation, a cut-off value of 0.6 was adopted, and the oral or anal approach was selected when the index was < or = 0.6 or > 0.6, respectively.


RESULTS
Data from 60 patients who underwent both VCE and DBE examinations and in whom the capsule reached the cecum were evaluated. Lesions shown on VCE were all reached by the first DBE procedures (41 orally and 19 anally). Based on the time index cut-off value of 0.6, the accuracy of selecting the insertion route of DBE was 100 %.


CONCLUSIONS
DBE is an effective approach for confirming VCE results. In patients with complete small-bowel investigation by VCE, the best insertion route for DBE can be reliably indicated using a time index based on the VCE records.
Li
X
X
Department of Gastroenterology, Shanghai Renji Hospital, Shanghai 200001, China.
Chen
H
H
Dai
J
J
Gao
Y
Y
Ge
Z
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007414:Intestinal Neoplasms / Q000175:diagnosis; D008875:Middle Aged; D055815:Young Adult