Capsule endoscopy (CE) has been widely used in clinical practice.
To provide systematically pooled results on the indications and detection, completion,
and retention rates of small-bowel CE.
A systematic review.
We searched the PubMed database (2000-2008) for original articles relevant to small-bowel
CE for the evaluation of patients with small-bowel signs and symptoms. Data on the
total number of capsule procedures, the distribution of different indications for
the procedures, the percentages of procedures with positive detection (detection rate),
complete examination (completion rate), or capsule retention (retention rate) were
extracted and/or calculated, respectively. In addition, the detection, completion,
and retention rates were also extracted and/or calculated in relation to indications
such as obscure GI bleeding (OGIB), definite or suspected Crohn's disease (CD), and
neoplastic lesions.
A total of 227 English-language original articles involving 22,840 procedures were
included. OGIB was the most common indication (66.0%), followed by the indication
of only clinical symptoms reported (10.6%), and definite or suspected CD (10.4%).
The pooled detection rates were 59.4%; 60.5%, 55.3%, and 55.9%, respectively, for
overall, OGIB, CD, and neoplastic lesions. Angiodysplasia was the most common reason
(50.0%) for OGIB. The pooled completion rate was 83.5%, with the rates being 83.6%,
85.4%, and 84.2%, respectively, for the 3 indications. The pooled retention rates
were 1.4%, 1.2%, 2.6%, and 2.1%, respectively, for overall and the 3 indications.
Inclusion and exclusion criteria were loosely defined.
The pooled detection, completion, and retention rates are acceptable for total procedures.
OGIB is the most common indication for small-bowel CE, with a high detection rate
and low retention rate. In addition, angiodysplasia is the most common finding in
patients with OGIB. A relatively high retention rate is associated with definite or
suspected CD and neoplasms.