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P208 Impact of Pillcam Crohn's capsule on diagnostic yield and clinical management: results of the first multi-centre, observational study

G. E. Tontini*1, F. Rizzello2, M. Topa1, F. Cavallaro3, G. Bonitta3, D. Gelli2, L. Pastorelli3,4, M. Salice2, M. Vecchi1,5, P. Gionchetti2, C. Calabrese2

1Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, 2IBD Unit, Department of Medical and Surgical Sciences (DIMEC), Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy, 3Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy, 4Department of Biomedical Sciences for Health, University of Milan, Milan, Italy, 5Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Background

A capsule endoscopy (CE) system tailored for Crohn’s disease (CD) patients has been recently developed. This new device features two advanced optics allowing a 344°-view between both capsule heads and a prolonged operative time, to provide the direct visualisation of the entire digestive tract. The present study has evaluated, for the first time, the performance of the PillCam™ Crohn’s System in a multi-centre real-life setting.

Methods

Consecutive patients with suspected or established CD were included between June 2017 and June 2018. Technical and clinical data, including the Lewis score and capsule impact on clinical management, were collected, thereby evaluating the added value of the 344° panoramic-view over the standard 172°-view.

Results

Among 41 patients (16 men; aged 43 ± 20 years), 73% underwent CE for suspected CD and 27% for established CD, with a mean time lapse of 12 years from diagnosis. The rate of complete enteroscopy was 90%. No technical failure or retention occurred. CE detected relevant lesions in 56.1% of patients, a Lewis score ≥135 in 51.4%, and had an impact on clinical management for 48.8% of patients. Compared with the standard 172° view, the panoramic 344°-view revealed a greater number of patients with a relevant lesion (56.1% vs. 39.0%; p = 0.023), resulting in higher Lewis score (222.8 vs. 185.7; p = 0.031), and improved clinical management (48.8% vs. 31.7%, p = 0.023).

Conclusion

The panoramic 344°-view improves both CE accuracy and the resulting clinical management of CD. This system should be regarded as a new standard for both small- bowel diagnosis and inflammatory bowel diseases monitoring.