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* = Presenting author

P177 Patency capsule in patients with established Crohn's disease undergoing videocapsule endoscopy of the small bowel

A. Nemeth1, U. Kopylov*2, A. Koulaouzidis3, G.W. Johansson4, R. Eliakim5, H. Thorlacius6, D. Amre7, R. Eliakim5, E.G. Seidman8, E. Toth4

1Skåne University Hospital, Lund University, Department of Gastroenterology, Malmo, Sweden, 2Sheba Medical Center, Gastroenterology, Tel Hashomer, Israel, 3Royal Infirmary of Edinburgh, Endoscopy Unit, Centre for Liver and Digestive Disorders, Edinburgh, United Kingdom, 4University Hospital Skane, Department of Hepatology and Gastroenterology, Malmö, Sweden, 5Chaim Sheba Medical Center, Gastroenterology, Ramat Gan, Israel, 6University Hospital Skane, Department of Surgery, Malmö, Sweden, 7Saint Justine Medical Center, Research Institute, Montreal, Canada, 8McGill University, Division of Gastroenterology, Montreal Quebec, Canada

Background

Video capsule endoscopy (VCE) is invaluable in diagnosis of small bowel (SB) pathology . Capsule retention is a major concern in patients with Crohn's disease (CD) . Patency capsule (PC) was designed to evaluate SB patency before VCE. However, the actual benefit of PC in CD is unclear. The aim of this study was to evaluate the impact of PC administration on capsule retention risk in patients with established CD

Methods

A retrospective multicenter study of CD patients undergoing VCE for established CD. PC utilization strategy was classified as selective (only in patients with obstructive symptoms , history of intestinal obstruction and surgery or per treating physician's request) or non-selective (in all patients). The main outcome was capsule retention in the entire cohort and each study arm.

Results

A total of 406 patients were included. VCE was performed in 132/406 (32.5%) cases without a prior PC. PC was performed in 274/406 (67.5%) and was negative in 193 patients. The risk of retention was 2.3% after VCE without PC and 2.1% after negative PC (p=0.9); 18/ 81 underwent VCE after positive PC with a retention rate of 11.1% ( p=0.001). PC failure was associated with an increased risk of capsule retention on a multivariate analysis. However, PC administration strategy was not associated with retention risk.

Conclusion

Capsule retention is a rare event in patients with established CD. The risk of capsule retention was not decreased by routine use of PC in all CD patients. VCE in CD patients after positive PC is associated with a high risk of capsule retention.

AN and UK have equally contributed to the study