title: Oesophageal capsule endoscopy versus oesophago-gastroduodenoscopy for the diagnosis of recurrent varices: a prospective multicentre study.
abstract: BACKGROUND
  Oesophago-gastroduodenoscopy is the standard method for the diagnosis of recurrent oesophago-gastric varices after endoscopic treatment and eradication. The aim of this study was to evaluate the PillCam Eso capsule endoscopy in this setting.
  
  
  METHODS
  Prospective, multicentre study in which patients with history of oesophageal varices treated by band ligation underwent PillCam Eso capsule and oesophago-gastroduodenoscopy. Capsule recordings were blindly read by two endoscopists. Indication for a new prophylactic treatment and patient satisfaction were determined for both procedures.
  
  
  RESULTS
  80 patients (80% males, mean age: 57±12 years) were included, after a median delay of 16 months from last endoscopic treatment. Recurrent oesophageal varices requiring a new prophylactic treatment were detected in 26 patients (32.5%). The mean oesophageal transit time of the capsule was 153 s (range 2-930 s). Capsule sensitivity, specificity, negative and positive predictive values for indication of new prophylactic treatments were 65%, 83%, 83%, and 65%, respectively. Capsule adequately classified 77.5% of the patients for prophylaxis indication. Inter-observer concordance for capsule readings was 88% for the prophylaxis indication.
  
  
  CONCLUSIONS
  This study demonstrates that accuracy of PillCam Eso capsule for the diagnosis of recurrent oesophageal varices after endoscopic eradication is suboptimal. PillCam Eso capsule might therefore be proposed in patients unable or unwilling to undergo oesophago-gastroduodenoscopy.
authors.affiliation: Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Laurain
authors.affiliation: Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France; Jean Mermoz Hospital, Lyon, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: de Leusse
authors.affiliation: Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Rodica
authors.initials: R
authors.lastname: Gincul
authors.affiliation: Archet II Hospital, Department of Digestive Diseases, Nice, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Vanbiervliet
authors.affiliation: Avignon Hospital, Department of Digestive Diseases, Avignon, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Slim
authors.initials: S
authors.lastname: Bramli
authors.affiliation: Conception Hospital - AP-HM, Department of Digestive Diseases, Marseille, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Heyries
authors.affiliation: Avignon Hospital, Department of Digestive Diseases, Avignon, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Martane
authors.affiliation: Ibn Sina Hospital, Department of Digestive Diseases, Rabat, Morocco; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Naima
authors.initials: N
authors.lastname: Amrani
authors.affiliation: Ibn Sina Hospital, Department of Digestive Diseases, Rabat, Morocco.
authors.forename: Ilham
authors.initials: I
authors.lastname: Serraj
authors.affiliation: Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France; Lyon Sud Hospital, Department of Digestive Diseases, Pierre Benite, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Saurin
authors.affiliation: Conception Hospital - AP-HM, Department of Digestive Diseases, Marseille, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Borentain
authors.affiliation: Saint Philibert Hospital, Department of Digestive Diseases, Lomme, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Filoche
authors.affiliation: Saint Philibert Hospital, Department of Digestive Diseases, Lomme, France.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Duburque
authors.affiliation: Cochin Hospital - AP-HP, Department of Digestive Endoscopy, Paris, France; Société Française d'Endoscopie Digestive, Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
authors.affiliation: Cochin Hospital - AP-HP, Department of Digestive Endoscopy, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.affiliation: Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France. Electronic address: jerome.dumortier@chu-lyon.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D057240:Patient Preference; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D016037:Single-Blind Method
keywords: Capsule; Cirrhosis; Diagnosis; Endoscopy; Esophageal varices; Portal hypertension; Tolerance