Nakamura Tetsuya, Terano Akira
Department of Gastrointestinal Endoscopy, Department of Medical Informatics, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan.
J Gastroenterol. 2008;43(2):93-9. doi: 10.1007/s00535-007-2153-6. Epub 2008 Feb 29.
A capsule endoscope is a swallowable wireless miniature camera for getting images of the gastrointestinal (GI) mucosa. The initial capsule endoscope model was developed by Given Imaging and approved in Western countries in 2001. Before the introduction of capsule endoscopy (CE) and double-balloon endoscopy (DBE), there was no effective modality for the evaluation and management of patients with obscure GI bleeding. Obscure GI bleeding is defined as bleeding of unknown origin that persists or recurs after a negative initial or primary endoscopy (colonoscopy or upper endoscopy) result. The first capsule endoscope model, which is now regarded as a first-line tool for the detection of abnormalities of the small bowel, was the PillCam SB. It was approved in Japan in April 2007. The main indication for use of the PillCam SB is obscure GI bleeding. Almost the only complication of CE is capsule retention, which is the capsule remaining in the digestive tract for a minimum of 2 weeks. A retained capsule can be retrieved by DBE. There are some limitations of CE in that it cannot be used to obtain a biopsy specimen or for endoscopic treatment. However, the combination of a PillCam SB and DBE seems to be the best strategy for management of obscure GI bleeding. Recently, several new types of capsule endoscope have been developed, such as Olympus CE for the small bowel, PillCam ESO for investigation of esophageal diseases, and PillCam COLON for detection of colonic neoplasias. In the near future, CE is expected to have a positive impact on many aspects of GI disease evaluation and management.
胶囊内镜是一种可吞咽的无线微型摄像头，用于获取胃肠道（GI）黏膜的图像。最初的胶囊内镜模型由Given Imaging公司研发，并于2001年在西方国家获得批准。在胶囊内镜检查（CE）和双气囊内镜检查（DBE）出现之前，对于不明原因的胃肠道出血患者，没有有效的评估和管理方法。不明原因的胃肠道出血定义为在初次或首次内镜检查（结肠镜检查或上消化道内镜检查）结果为阴性后持续或复发的不明来源出血。第一款胶囊内镜模型PillCam SB，如今被视为检测小肠异常的一线工具，于2007年4月在日本获得批准。PillCam SB的主要使用指征是不明原因的胃肠道出血。CE几乎唯一的并发症是胶囊滞留，即胶囊在消化道内停留至少2周。滞留的胶囊可通过DBE取出。CE存在一些局限性，即它不能用于获取活检标本或进行内镜治疗。然而，PillCam SB和DBE的联合似乎是管理不明原因胃肠道出血的最佳策略。最近，已经研发出几种新型胶囊内镜，如用于小肠检查的Olympus CE、用于食管疾病检查的PillCam ESO以及用于检测结肠肿瘤的PillCam COLON。在不久的将来，CE有望在胃肠道疾病评估和管理的许多方面产生积极影响。
