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. (Gastrointest Endosc 2009;69:74-80.)