String capsule endoscopy for screening and surveillance of esophageal varices in patients with cirrhosis

Stipho, Sally; Tharalson, Erin; Hakim, Shahina; Akins, Rodney; Shaukat, Masud; Ramirez, Francisco C.

doi:10.4161/jig.22173

Cited by 11 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sensitivity and specificity in this study reached 96% and 100%, respectively. However, these results were not validated by another string capsule study, which showed sensitivity and specificity of 84% and 72%, respectively [ 106 ]. Nevertheless, it has been shown that string capsule endoscopy improves visualization of the distal esophagus, which may potentially have an impact on the detection of esophageal varices [ 107 ].…”

Section: Resultsmentioning

confidence: 90%

Νon-invasive screening for esophageal varices in patients with liver cirrhosis

Karatzas¹,

Konstantakis

Αγγελετοπούλου³

et al. 2018

aog

View full text Add to dashboard Cite

Esophageal varices are one of the main complications of liver cirrhosis. Upper gastrointestinal endoscopy is the gold standard for the detection of esophageal varices. Many less invasive methods for screening of varices have been investigated and the most recent Baveno VI guidelines suggest that endoscopy is not necessary in patients with liver stiffness <20 kPa and platelets >150,000/μL. A critical review of the literature was performed concerning non-invasive or minimally invasive methods of screening for esophageal varices. Liver and spleen elastography, imaging methods including computed tomography, magnetic resonance imaging and ultrasound, laboratory tests and capsule endoscopy are discussed. The accuracy of each method, and its advantages and limitations compared to endoscopy are analyzed. There are data to support the Baveno VI guidelines, but there is still a lack of large prospective studies and low specificity has been reported for the liver stiffness and platelet count combination. Spleen elastography has shown promising results, as there are data to support its superiority to liver elastography, but it needs further assessment. Computed tomography has shown high diagnostic accuracy and can be part of the diagnostic work up of cirrhotic patients in the future, including screening for varices.

show abstract

Section: Resultsmentioning

confidence: 90%

Νon-invasive screening for esophageal varices in patients with liver cirrhosis

Karatzas¹,

Konstantakis

Αγγελετοπούλου³

et al. 2018

aog

View full text Add to dashboard Cite

show abstract

“…In 16 studies, the accuracy of capsule endoscopy in assessing the presence of any varices regardless of size was estimated. 20–35 The remaining one study assessed the accuracy of capsule endoscopy for only large, high-risk esophageal varices. 37 A total of 7 studies evaluated the use of wireless capsule endoscopy for medium or large varices.…”

Section: Resultsmentioning

confidence: 99%

Use of Wireless Capsule Endoscopy for the Diagnosis and Grading of Esophageal Varices in Patients With Portal Hypertension

McCarty

Afinogenova²,

Njei³

2017

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

INTRODUCTION Esophageal variceal bleeding is a severe complication of portal hypertension with significant morbidity and mortality. While traditional screening and grading of esophageal varices has been performed by endogastroduodenoscopy (EGD), wireless video capsule endoscopy provides a minimally-invasive alternative that may improve screening and surveillance compliance. AIM To perform a systematic review and structured meta-analysis of all eligible studies to evaluate the efficacy of wireless capsule endoscopy for screening and diagnosis of esophageal varices among patients with portal hypertension. METHODS Searches of PubMed, EMBASE, Web of Science, and the Cochrane Library databases were performed through December 2015. Bivariate and hierarchical models were used to compute the pooled sensitivity and specificity, and to plot the summary receiver operating characteristics curve with summary point and corresponding 95 % confidence region. Bias of included studies was assessed using the quality assessment of diagnostic accuracy studies (QUADAS-2). RESULTS Seventeen studies from 2005 to 2015 were included in this meta-analysis (n=1,328). The diagnostic accuracy of wireless capsule endoscopy in the diagnosis of esophageal varices was 90% (95% CI, 0.88–0.93). The diagnostic pooled sensitivity and specificity were 83% (95% CI, 0.76 – 0.89) and 85% (95% CI, .75–0.91), respectively. The diagnostic accuracy of wireless capsule endoscopy for the grading of medium to large varices was 92% (95% CI, 0.90–0.94). The pooled sensitivity and specificity were 72% (95% CI, 0.54–0.85) and 91% (95% CI, 0.86–0.94), respectively, for the grading of medium to large varices. The use of capsule demonstrated only mild adverse events. A sensitivity analysis limited to only high quality studies revealed similar results. DISCUSSION Wireless esophageal capsule endoscopy is well tolerated and safe in patients with liver cirrhosis and suspicion of portal hypertension. The sensitivity of capsule endoscopy is not currently sufficient to replace EGD as a first exploration in these patients, but given its high accuracy, it may have a role in cases of refusal or contraindication to EGD.

show abstract

“…Previous studies have shown that attachment of a string prolongs the transit time of the PillCam SB capsule endoscope and improves the diagnostic accuracy of esophageal diseases [8,9]. However, the PillCam SB capsule endoscope is normally designated for small bowel examination, but is not suitable for viewing esophageal mucosa because of a limited shooting frequency of 2 frames/s.…”

Section: Discussionmentioning

confidence: 98%

“…The strings were removed and the capsule was rinsed in sterile water and disinfected in 2% glutaraldehyde solution for 45 min as described previously by Stipho et al [9] The volunteer was subsequently instructed to swallow the ECE using a standardized ECE ingestion protocol [10].…”

Section: Preparation Of String Capsule Endoscopementioning

confidence: 99%

String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line

Chen¹,

Zhu

et al. 2014

European Journal of Gastroenterology & Hepatology

View full text Add to dashboard Cite

show abstract

String capsule endoscopy for screening and surveillance of esophageal varices in patients with cirrhosis

Abstract: String capsule endoscopy had an acceptable sensitivity and specificity for the diagnosis of clinically significant esophageal varices but the lack of air insufflation still hampers its correlation with the grading used with EGD.

Cited by 11 publications

References 27 publications

Νon-invasive screening for esophageal varices in patients with liver cirrhosis

Νon-invasive screening for esophageal varices in patients with liver cirrhosis

Use of Wireless Capsule Endoscopy for the Diagnosis and Grading of Esophageal Varices in Patients With Portal Hypertension

String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line

Contact Info

Product

Resources

About