Retrieval of Retained Capsule Endoscopy at Small Bowel Stricture by Double-Balloon Endoscopy Significantly Decreases Surgical Treatment.
OBJECTIVE
The aim is to elucidate the efficacy and safety of double-balloon endoscopy (DBE) for small bowel capsule endoscopy (SBCE) retrieval from small bowel stricture and to follow the outcome of the stricture where the SBCE was entrapped.


BACKGROUND
The retention of SBCE is a serious adverse event and most retained capsules are retrieved by surgery. There is still no report analyzing the follow-up of patients with stricture after retrieval of entrapped SBCEs by DBE.


METHODS
This study was designed a retrospective cohort study. Subjects were 12 consecutive patients with small bowel stricture where retrieval of entrapped SBCE was attempted using DBE. Success rate of the SBCE retrieval by DBE, surgical rate of the small bowel stricture, adverse events of DBE, and outcomes in the follow-up period were evaluated.


RESULTS
Diagnoses were Crohn's disease, nonsteroidal anti-inflammatory drugs-induced enteropathy, ischemic enteritis, and carcinoma in 8, 2, 1, and 1 patients, respectively. SBCE was successfully retrieved in 11 of the 12 patients (92%). No adverse events were encountered in all endoscopic procedures such as retrieval of SBCEs and dilation of the strictures. Nine of the 12 patients (75%) did not undergo surgical treatment for the stricture where SBCE was entrapped through the follow-up period (mean, 1675±847 d).


CONCLUSIONS
Retrieval of SBCEs using DBE was safe, had a high success rate, and was useful to evaluate the need for surgery. Seventy-five percent of patients with small bowel stricture where the SBCE was entrapped did not require surgery through approximately 5 years.
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
Keigo
K
Mitsui
Shunji
S
Fujimori
Shu
S
Tanaka
Akihito
A
Ehara
Jun
J
Omori
Naohiko
N
Akimoto
Kotaro
K
Maki
Masahiro
M
Suzuki
Yuki
Y
Kosugi
Yukiko
Y
Ensaka
Yoko
Y
Matsuura
Tsuyoshi
T
Kobayashi
Masaoki
M
Yonezawa
Atsushi
A
Tatsuguchi
Choitsu
C
Sakamoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000009:adverse effects / Q000295:instrumentation*; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult