Double-balloon endoscopy as the primary method for small-bowel video capsule endoscope retrieval Disclosure

BackgroundCapsule retention in the small bowel is a known complication of small-bowel video capsule endoscopy. Surgery is the most frequently used method of capsule retrieval.ObjectiveTo determine the incidence and causes of capsule retention and to describe double-balloon endoscopy (DBE) as the primary technique used for capsule retrieval.DesignRetrospective analysis of all video capsule studies was performed at our center, and evaluation of the outcome of DBE was the first method used to retrieve entrapped video capsules.SettingTertiary referral center.PatientsA total of 904 patients who underwent small-bowel video capsule endoscopy.InterventionsCapsule retrieval by DBE.Main Outcome MeasurementsThe number of patients in whom capsule retention occurred and the number of patients in whom an entrapped capsule could be retrieved by using DBE.ResultsCapsule retention occurred in 8 patients (incidence 0.88%; 95% CI, 0.41%-1.80%) and caused acute small-bowel obstruction in 6 patients. All retained capsules were successfully removed during DBE. Five patients underwent elective surgery to treat the underlying cause of capsule retention. One patient required emergency surgery because of multiple small-bowel perforations.LimitationsRetrospective design.ConclusionsIn our series, the incidence of capsule retention was low. DBE is a reliable method for removing retained capsules and might prevent unnecessary surgery. If surgery is required, preoperative capsule retrieval allows preoperative diagnosis, adequate staging in case of malignancy, and optimal surgical planning.