Risk factors for incomplete small-bowel capsule endoscopy.

BACKGROUND

In 20% to 30% of capsule endoscopy (CE) procedures, the capsule does not reach the cecum within recording time, with incomplete imaging of the small bowel, which limits the value of CE.

OBJECTIVE

To identify possible risk factors for incomplete small-bowel CE examinations.

DESIGN

Data from consecutive CE procedures performed between September 2003 and August 2007 were analyzed. All patients had received the same preparation before the CE procedure, including the administration of a prokinetic agent.

SETTING

Single-center retrospective study.

PATIENTS

A total of 291 CE studies.

MAIN OUTCOME MEASUREMENTS

Data were collected regarding patient demographics and potential risk factors. Cecal incompletion rates were calculated. Risk factors were analyzed by using a binary regression analysis.

RESULTS

CE was incomplete in 55 cases (19%). The gastric transit time was significantly longer in patients with incomplete CE procedures than in patients with complete CE procedures (median 45 minutes vs 21 minutes, P= .005). Previous small-bowel surgery, hospitalization, moderate or poor bowel cleansing, and a gastric transit time longer than 45 minutes were identified as independent risk factors for incomplete CE procedures.

LIMITATION

A retrospective study design.

CONCLUSIONS

The identification of several risk factors for incomplete CE procedures allows for selectively targeting these factors in future procedures to reduce the risk of incomplete CE examinations.