Endoscopy 2019; 51(04): S9
DOI: 10.1055/s-0039-1681196
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Capsule 1 Club B
Georg Thieme Verlag KG Stuttgart · New York

SINGLE-CENTRE EXPERIENCE USING UPPER GASTROINTESTINAL (UGI) CAPSULE AS AN ALTERNATIVE TO DIAGNOSTIC GASTROSCOPY

F D'Errico
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
A Crudeli
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
DM Borrow
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
C Morre
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
E Mangsat
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
R Hampal
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
S Meade
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
R Reynolds
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
SH Anderson
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
,
I Nasr
1   Guy's and St Thomas' NHS Foundation Trust, Gastroenterology, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

The demand for diagnostic upper gastrointestinal (UGI) endoscopy is high, often exceeding the resources. UGI capsule has already been shown to be an effective diagnostic tool to detect UGI diseases but its cost effectiveness has not been investigated yet. The aim of this study was to evaluate the diagnostic ability and costs of UGI capsule.

Methods:

This is an observational study of patients who had a UGI capsule endoscopy between April 2017 and November 2018 at Guy's and St Thomas' Hospital. Patients swallowed the UGI capsule (ESO3, Medtronic) following ingestion of 1 liter of water (containing simethicone). A series of positional changes were used to facilitate the UGI capsule transit. Indications for the procedure, quality indicators and findings were evaluated.

Results:

76 patients were included in the study: 55 preferred capsule, 1 was not suitable for a gastroscopy, 10 failed gastroscopy and 10 would require general anesthesia. Regarding the indications, the majority had heartburn (30%) followed by abdominal pain (22%) and iron deficiency anemia (15%). The UGI capsule reached D2 in 73% of patients. Ampulla pick up rate (13.5%), incisura, fundus and cardias pick up rates (100%), inlet patch pick up rate (9.5%) were considered as quality indicators. The following findings were reported: 34 normal, 15 gastritis, 9 fundic glands polyps, 7 oesophagitis, 3 hiatus haernia, 1 Barrett's. Of note, only 4 (5%) needed a gastroscopy thereafter (further assessment/biopsies). In the majority of UGI capsules the results were conclusive. UGI capsule costs have been estimated around £412 per procedure. The tariff for one procedure is £970 (total earned £557). In comparison, a gastroscopy costs approximately £66 per procedure with a tariff of £341 (total earned £275).

Conclusions:

UGI capsule is a potential, non-invasive, cost-effective alternative to diagnostic UGI endoscopy. Further improvement are needed to increase ampulla pick up rate and completion rate.