Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

AbstractThe European Society of Gastrointestinal Endoscopy (ESGE) together with the United European Gastroenterology (UEG) recently developed a short list of performance measures for small-bowel endoscopy (i. e. small-bowel capsule endoscopy and device-assisted enteroscopy) with the final goal of providing endoscopy services across Europe with a tool for quality improvement. Six key performance measures for both small-bowel capsule endoscopy and for device-assisted enteroscopy were selected for inclusion, with the intention being that practice at both a service and endoscopist level should be evaluated against them. Other performance measures were considered to be less relevant, based on an assessment of their overall importance, scientific acceptability, and feasibility. Unlike lower and upper gastrointestinal endoscopy, where performance measures had already been identified, this is the first time that small-bowel endoscopy quality measures have been proposed.

Download Full-text

Correction: Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopy ◽

10.1055/a-1204-5396 ◽

2020 ◽

Vol 52 (08) ◽

pp. C9-C9

Author(s):

Reena Sidhu ◽

Stefania Chetcuti Zammit ◽

Peter Baltes ◽

Cristina Carretero ◽

Edward J. Despott ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Position Statement

Download Full-text

European Society of Gastrointestinal Endoscopy (ESGE) Guidelines: flexible enteroscopy for diagnosis and treatment of small-bowel diseases

Endoscopy ◽

10.1055/s-2008-1077371 ◽

2008 ◽

Vol 40 (07) ◽

pp. 609-618 ◽

Cited By ~ 24

Author(s):

J. Pohl ◽

M. Delvaux ◽

C. Ell ◽

G. Gay ◽

A. May ◽

...

Keyword(s):

Small Bowel ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Diagnosis And Treatment ◽

Bowel Diseases ◽

Small Bowel Diseases

Download Full-text

Adherence to European Society of Gastrointestinal Endoscopy recommendations of endoscopists performing small bowel capsule endoscopy in Italy

Digestive and Liver Disease ◽

10.1016/j.dld.2018.11.031 ◽

2019 ◽

Vol 51 (6) ◽

pp. 818-823 ◽

Cited By ~ 2

Author(s):

Emanuele Rondonotti ◽

Cristiano Spada ◽

Marco Pennazio ◽

Roberto de Franchis ◽

Sergio Cadoni ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

European Society ◽

Gastrointestinal Endoscopy

Download Full-text

European Society of Gastrointestinal Endoscopy (ESGE): Recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases

Endoscopy ◽

10.1055/s-0029-1243968 ◽

2010 ◽

Vol 42 (03) ◽

pp. 220-227 ◽

Cited By ~ 150

Author(s):

S. Ladas ◽

K. Triantafyllou ◽

C. Spada ◽

M. Riccioni ◽

J.-F. Rey ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Video Capsule Endoscopy ◽

Clinical Use ◽

Colonic Diseases

Download Full-text

Implementation of European Society of Gastrointestinal Endoscopy (ESGE) recommendations for small-bowel capsule endoscopy into clinical practice: Results of an official ESGE survey

Endoscopy ◽

10.1055/a-1541-2938 ◽

2021 ◽

Author(s):

Lazaros-Dimitrios Lazaridis ◽

Georgios Tziatzios ◽

Ervin Toth ◽

Hanneke Beaumont ◽

Xavier Dray ◽

...

Keyword(s):

Crohn’S Disease ◽

Clinical Practice ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Bowel Preparation ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Deficiency Anemia ◽

National Society

Abstract Background We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations. Methods Participants reached through the ESGE contact list completed a 52-item web-based survey. Results 217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn’s disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn’s disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( > 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %). Conclusions To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.

Download Full-text

Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopy ◽

10.1055/a-1185-1289 ◽

2020 ◽

Vol 52 (08) ◽

pp. 669-686

Author(s):

Reena Sidhu ◽

Stefania Chetcuti Zammit ◽

Peter Baltes ◽

Cristina Carretero ◽

Edward J. Despott ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Position Statement ◽

Multiple Choice Questions ◽

Hands On ◽

Therapeutic Procedures ◽

Standard Terminology ◽

Small Bowel Endoscopy

Main RecommendationsThe European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize training in small-bowel endoscopy across European centers. The following criteria and framework for training in small-bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE), which aim to provide uniform and high quality training to ensure that small-bowel endoscopists are competent to operate independently, are based on the current literature and experience of experts in the field. Three main areas are covered: skills required prior to commencing training in small-bowel endoscopy; structured training for trainees to become independent endoscopists; and ways of ensuring competence is achieved. 1 Centers providing training in SBCE should perform a minimum of 75 – 100 SBCEs/year. 2 Experience in bidirectional endoscopies is desirable for structured training in SBCE. 3 SBCE courses should consist of at least 50 % hands-on training and cover information on technology, indications and contraindications for SBCE, pathologies that can be encountered on SBCE, and standard terminology that should be used during reporting of SBCE. An SBCE course should be completed prior to achieving competence in SBCE reporting. 4 Competence in SBCE can be assessed by considering a minimum of 30 SBCEs. Direct Observation of Procedural Skills, short SBCE videos, and multiple-choice questions can be useful to assess improvement in the skills of trainees. 5 Centers offering training in DAE should aim to carry out at least 75 DAEs/year, should have direct links with an SBCE service, and should allow regular discussion of cases at a radiology small-bowel MDT. Training centers with lower numbers are encouraged to offer training by “buddying-up” with other centers, or using mentoring systems. 6 DAE trainees must be independent in bidirectional endoscopies and have experience in level 1 polypectomy prior to commencement of training. They should also be competent in reviewing SBCEs. 7 Training in DAE should be structured with a minimum of 75 procedures, including 35 retrograde DAEs, with therapeutic procedures undertaken in at least 50 % of the DAEs performed. Training should cover the indications, contraindications, complications including prevention, and technicalities of the DAE procedure; formal evaluation should follow. DAE trainees must acquire skills to independently manage and advise on small-bowel pathology following DAE procedures. 8 It is highly recommended that international societies develop online modules and courses on DAE, which are currently lacking across Europe.

Download Full-text