Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2677
Peer-review started: August 16, 2014
First decision: September 15, 2014
Revised: September 25, 2014
Accepted: October 21, 2014
Article in press: October 21, 2014
Published online: March 7, 2015
Processing time: 205 Days and 7.5 Hours
AIM: To determine if longer battery life improves capsule endoscopy (CE) completion rates.
METHODS: A retrospective study was performed at a tertiary, university-affiliated hospital in Vancouver, Canada. Patients who underwent CE with either PillCam™ SB2 or SB2U between 01/2010 and 12/2013 were considered for inclusion. SB2 and SB2U share identical physical dimensions but differ in their battery lives (8 h vs 12 h). Exclusion criteria included history of gastric or small bowel surgery, endoscopic placement of CE, interrupted view of major landmarks due to technical difficulty or significant amount of debris, and repeat CE using same system. Basic demographics, comorbidities, medications, baseline bowel habits, and previous surgeries were reviewed. Timing of major landmarks in CE were recorded, and used to calculate gastric transit time, small bowel transit time, and total recording time. A complete CE study was defined as visualization of cecum. Transit times and completion rates were compared.
RESULTS: Four hundred and eight patients, including 208 (51.0%) males, were included for analysis. The mean age was 55.5 ± 19.3 years. The most common indication for CE was gastrointestinal bleeding (n = 254, 62.3%), followed by inflammatory bowel disease (n = 86, 21.1%). There was no difference in gastric transit times (group difference 0.90, 95%CI: 0.72-1.13, P = 0.352) and small bowel transit times (group difference 1.07, 95%CI: 0.95-1.19, P = 0.261) between SB2U and SB2, but total recording time was about 14% longer in the SB2U group (95%CI: 10%-18%, P < 0.001) and there was a corresponding trend toward higher completion rate (88.2% vs 93.2%, OR = 1.78, 95%CI 0.88-3.63, P = 0.111). There was no statistically significant difference in the rates of positive findings (OR = 0.98, 95%CI: 0.64-1.51, P = 0.918).
CONCLUSION: Extending the operating time of CE may be a simple method to improve completion rate although it does not affect the rate of positive findings.
Core tip: This is the first study, to our knowledge, to specifically examine the effect of battery life on capsule endoscopy completion rate (i.e., complete visualization of the entire small bowel). Capsule endoscopies performed using SB2U had longer recording time and a corresponding trend toward higher completion rate than the older-generation SB2. As the two systems are identical in dimensions, there was no difference in the transit times. There was no difference in the rates of positive findings. A randomized controlled trial would be necessary to confirm the diagnostic advantage of longer battery life in capsule endoscopy.