Anne Laurain1, Antoine de Leusse2, Rodica Gincul3, Geoffroy Vanbiervliet4, Slim Bramli5, Laurent Heyries6, Gabriel Martane5, Naima Amrani7, Ilham Serraj8, Jean-Christophe Saurin9, Patrick Borentain10, Bernard Filoche11, Clotilde Duburque12, Marianne Gaudric13, Philippe Sogni14, Jérôme Dumortier15. 1. Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France. 2. 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. 3. Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France; Société Française d'Endoscopie Digestive, Paris, France. 4. Archet II Hospital, Department of Digestive Diseases, Nice, France; Société Française d'Endoscopie Digestive, Paris, France. 5. Avignon Hospital, Department of Digestive Diseases, Avignon, France; Société Française d'Endoscopie Digestive, Paris, France. 6. Conception Hospital - AP-HM, Department of Digestive Diseases, Marseille, France; Société Française d'Endoscopie Digestive, Paris, France. 7. Ibn Sina Hospital, Department of Digestive Diseases, Rabat, Morocco; Société Française d'Endoscopie Digestive, Paris, France. 8. Ibn Sina Hospital, Department of Digestive Diseases, Rabat, Morocco. 9. 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. 10. Conception Hospital - AP-HM, Department of Digestive Diseases, Marseille, France. 11. Saint Philibert Hospital, Department of Digestive Diseases, Lomme, France; Société Française d'Endoscopie Digestive, Paris, France. 12. Saint Philibert Hospital, Department of Digestive Diseases, Lomme, France. 13. Cochin Hospital - AP-HP, Department of Digestive Endoscopy, Paris, France; Société Française d'Endoscopie Digestive, Paris, France. 14. Cochin Hospital - AP-HP, Department of Digestive Endoscopy, Paris, France. 15. Edouard Herriot Hospital - HCL, Department of Digestive Diseases, Claude Bernard Lyon 1 University, Lyon, France. Electronic address: jerome.dumortier@chu-lyon.fr.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Federico Ravaioli; Marco Montagnani; Andrea Lisotti; Davide Festi; Giuseppe Mazzella; Francesco Azzaroli Journal: Gastroenterol Res Pract Date: 2018-06-07 Impact factor: 2.260
Authors: Hey-Long Ching; Ailish Healy; Victoria Thurston; Melissa F Hale; Reena Sidhu; Mark E McAlindon Journal: World J Gastroenterol Date: 2018-07-14 Impact factor: 5.742