Small-Bowel Capsule Endoscopy Procedure and Review
bleeding, tumors, ulcers
BLEEDING, TUMORS, ULCERS, ANGIOECTASIAS, VARICES
The device used for the SBCE procedure was PillCam SB3® (Medtronic, Dublin, Ireland). Patients were given instructions to start a clear liquid diet 24 hours prior to the exam and to fast for 12 hours before the examThe SBCE videos were reviewed by gastroenterologists experienced in capsule reading (>500 reviews), using the RAPID Reader® software (Medtronic). The reading was performed at a maximum speed of 10 frames per second in a single-view mode, as previously recommended.Endoscopic data were collected by reviewing SBCE examination records and included gastric transit time, small-bowel transit time, small-bowel preparation quality, relevant endoscopic findings defined as the presence of P2 lesions (high bleeding potential, such as angioectasias, ulcers, tumors, or varices), according to Saurin Gastric transit time was defined as the time in which SBCE remained in the stomach, determined after selecting the first gastric and duodenal landmarks in the RAPID Reader® software. Small-bowel transit was defined as the time in which SBCE remained in the small bowel, determined after selecting the first duodenal and cecal landmarks, or alternatively the last image of the small bowel if the capsule did not reach the cecum within recording time.Prolonged gastric transit time was defined as SBCE remaining in the stomach for more than 1 hour due to delayed gastric transit, as checked with the systematic use of the real-time viewer. In these cases, 10 mg of domperidone was administered orally and the location of the capsule was rechecked after 30 minutes with the real-time viewer. If it still remained in the stomach, an additional dose of 10 mg of domperidone was administered orally, and after another 30 minutes, the location of the capsule was rechecked; then if still in the stomach, the capsule was placed directly in the duodenum by upper endoscopy using a basket or snare.An incomplete examination was defined when SBCE did not reach the cecum within the battery time.To assess the quality of small-bowel cleansing, we followed a method similar to other publications,