title: Double-balloon endoscopy as the primary method for small-bowel video capsule endoscope retrieval.
abstract: BACKGROUND
  Capsule retention in the small bowel is a known complication of small-bowel video capsule endoscopy. Surgery is the most frequently used method of capsule retrieval.
  
  
  OBJECTIVE
  To determine the incidence and causes of capsule retention and to describe double-balloon endoscopy (DBE) as the primary technique used for capsule retrieval.
  
  
  METHODS
  Retrospective analysis of all video capsule studies was performed at our center, and evaluation of the outcome of DBE was the first method used to retrieve entrapped video capsules.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  A total of 904 patients who underwent small-bowel video capsule endoscopy.
  
  
  METHODS
  Capsule retrieval by DBE.
  
  
  METHODS
  The number of patients in whom capsule retention occurred and the number of patients in whom an entrapped capsule could be retrieved by using DBE.
  
  
  RESULTS
  Capsule retention occurred in 8 patients (incidence 0.88%; 95% CI, 0.41%-1.80%) and caused acute small-bowel obstruction in 6 patients. All retained capsules were successfully removed during DBE. Five patients underwent elective surgery to treat the underlying cause of capsule retention. One patient required emergency surgery because of multiple small-bowel perforations.
  
  
  CONCLUSIONS
  Retrospective design.
  
  
  CONCLUSIONS
  In our series, the incidence of capsule retention was low. DBE is a reliable method for removing retained capsules and might prevent unnecessary surgery. If surgery is required, preoperative capsule retrieval allows preoperative diagnosis, adequate staging in case of malignancy, and optimal surgical planning.
authors.affiliation: Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Stijn J B
authors.initials: SJ
authors.lastname: Van Weyenberg
authors.forename: Sietze T
authors.initials: ST
authors.lastname: Van Turenhout
authors.forename: Gerd
authors.initials: G
authors.lastname: Bouma
authors.forename: Jan Hein T M
authors.initials: JH
authors.lastname: Van Waesberghe
authors.forename: Donald L
authors.initials: DL
authors.lastname: Van der Peet
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: Maarten A J M
authors.initials: MA
authors.lastname: Jacobs
mesh_terms: D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000628:therapy*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies