Scandinavian journal of gastroenterology · 2026
Safety and performance of small bowel capsule endoscopy in patients with surgically altered gastrointestinal anatomy.
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Naseem Zehra, Kaul Ridhima, Prado Renan, Chatterjee Arjun, Aggarwal Manik, Nasser Jason, Wu Yueqi, Yang Qijun, McMichael John, Kundu Rupayan, Funk Cynthia, Ford Andrew, Simons-Linares C Roberto, Rubio-Tapia Alberto
Аннотация
BACKGROUND: To study the performance and efficacy of small bowel capsule endoscopy (SBCE) in a large cohort of patients with surgically altered gastrointestinal anatomy (SAGA).
METHODS: We retrospectively reviewed all SBCE studies between January 2000 and August 2025. Patients with SAGA (prior gastrectomy, gastric bypass, small bowel resections, esophagectomy, or Whipple procedures) were matched 1:2 to patients with native gastrointestinal (GI) anatomy. Primary outcome was SBCE completion rate. Secondary outcomes included diagnostic yield, capsule retention, and GI transit times.
RESULTS: A total of 102 patients with SAGA were matched to 204 patients with native GI anatomy. Gastric bypass was the most common surgical history among SAGA patients (n = 47; 46%). Use of patency capsule prior to SBCE ingestion was more frequent in the SAGA group (27% vs. 6%, p < 0.01). The most common indication for SBCE was overt GI bleeding (SAGA 43% vs. native 60%, p = 0.01).Completion rates were similar (SAGA 95% vs. native 94%, p = 0.93). Capsule retention requiring endoscopic or surgical retrieval occurred only in the native anatomy group (n = 3). Median total transit time was shorter in the SAGA group (731 vs. 818 min, p < 0.01), while median small bowel transit time was similar between the groups. Overall diagnostic yield was similar between the groups (SAGA: 48% vs. native GI anatomy: 57.4%, p = 0.13).
CONCLUSIONS: SBCE is effective in patients with SAGA, demonstrating comparable completion rates and similar diagnostic yield to patients with native GI anatomy.
METHODS: We retrospectively reviewed all SBCE studies between January 2000 and August 2025. Patients with SAGA (prior gastrectomy, gastric bypass, small bowel resections, esophagectomy, or Whipple procedures) were matched 1:2 to patients with native gastrointestinal (GI) anatomy. Primary outcome was SBCE completion rate. Secondary outcomes included diagnostic yield, capsule retention, and GI transit times.
RESULTS: A total of 102 patients with SAGA were matched to 204 patients with native GI anatomy. Gastric bypass was the most common surgical history among SAGA patients (n = 47; 46%). Use of patency capsule prior to SBCE ingestion was more frequent in the SAGA group (27% vs. 6%, p < 0.01). The most common indication for SBCE was overt GI bleeding (SAGA 43% vs. native 60%, p = 0.01).Completion rates were similar (SAGA 95% vs. native 94%, p = 0.93). Capsule retention requiring endoscopic or surgical retrieval occurred only in the native anatomy group (n = 3). Median total transit time was shorter in the SAGA group (731 vs. 818 min, p < 0.01), while median small bowel transit time was similar between the groups. Overall diagnostic yield was similar between the groups (SAGA: 48% vs. native GI anatomy: 57.4%, p = 0.13).
CONCLUSIONS: SBCE is effective in patients with SAGA, demonstrating comparable completion rates and similar diagnostic yield to patients with native GI anatomy.