Efficacy of capsule endoscopy in patients with cirrhosis for the diagnosis of upper gastrointestinal lesions and small bowel abnormalities: a study protocol for prospective interventional study

Introduction and aims The role of capsule endoscopy (CE) in patients with liver cirrhosis (LC) has yet to be established; however, it is likely that it will remain a valuable diagnostic modality in several groups of patients with LC. The primary aims of the current prospective interventional study are to examine the prevalence for small bowel lesions and transit time of CE in the gastrointestinal tract in patients with LC with oesophageal varices (EVs) requiring endoscopic therapies. Methods and analysis The current study will be a single-centre prospective interventional study. Our study participants are LC subjects with portal hypertension who were determined to be necessary for prophylactic endoscopic therapies for EVs. From the view point of safety, patients with gastrointestinal obstruction or fistula or those being suspected of having gastrointestinal obstruction or fistula will be excluded from our study. Patients with implanted medical devices will be also excluded. CE will be performed prior to prophylactic endoscopic therapies in the same hospitalisation and relevant images will be analysed after 8 hours by expert endoscopists. This study will continue to recruit until 50 participants. Ethics and dissemination This study has received approval from the Institutional Review Board at Hyogo College of Medicine (approval no. 2680). The study protocol, informed assent form and other submitted files were reviewed and acknowledged. Final data will be publicly scattered regardless of the study results. A report releasing study results will be submitted for publication in a suitable journal after being finished in data collection. Trial registration number UMIN000028433 (https://upload.umin.ac.jp/).

[1]  N. Ohmiya,et al.  Associations between drugs and small‐bowel mucosal bleeding: Multicenter capsule‐endoscopy study , 2018, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[2]  E. Rondonotti,et al.  Systematic review and meta-analysis: is bowel preparation still necessary in small bowel capsule endoscopy? , 2017, Expert review of gastroenterology & hepatology.

[3]  Anastasios Koulaouzidis,et al.  Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohn's disease: Systematic review and meta-analysis. , 2017, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[4]  T. Matsui,et al.  Clinical Practice Guideline for Enteroscopy , 2017, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[5]  R. Fitzgerald,et al.  Alternatives to Traditional Per-Oral Endoscopy for Screening. , 2017, Gastrointestinal endoscopy clinics of North America.

[6]  R. Takata,et al.  Effect of psoas muscle mass after endoscopic therapy for patients with esophageal varices , 2017, Medicine.

[7]  G. Tziatzios,et al.  Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding. , 2017, Annals of translational medicine.

[8]  E. Rondonotti Capsule retention: prevention, diagnosis and management. , 2017, Annals of translational medicine.

[9]  T. McCarty,et al.  Use of Wireless Capsule Endoscopy for the Diagnosis and Grading of Esophageal Varices in Patients With Portal Hypertension: A Systematic Review and Meta-Analysis , 2017, Journal of clinical gastroenterology.

[10]  David Armstrong,et al.  Clinical Practice Guidelines for the Use of Video Capsule Endoscopy. , 2017, Gastroenterology.

[11]  A. Day,et al.  Lack of benefit of active preparation compared with a clear fluid-only diet in small-bowel visualization for video capsule endoscopy: results of a randomized, blinded, controlled trial. , 2017, Gastrointestinal endoscopy.

[12]  F. Carballo Álvarez,et al.  Diagnostic and therapeutic features of small bowel involvement in portal hypertension. , 2017, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[13]  Anastasios Koulaouzidis,et al.  Capsule endoscopy of the small bowel. , 2016, Annals of translational medicine.

[14]  K. Sugano,et al.  Evidence-based clinical practice guidelines for liver cirrhosis 2015 , 2016, Journal of Gastroenterology.

[15]  P. Hayes,et al.  Small bowel capsule endoscopy and portal hypertensive enteropathy in cirrhotic patients: results from a tertiary referral centre. , 2016, Annals of hepatology.

[16]  S. Kantsevoy,et al.  Esophageal capsule endoscopy is not the optimal technique to determine the need for primary prophylaxis in patients with cirrhosis , 2016, Archives of medical science : AMS.

[17]  Wei-xin Liu,et al.  Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage: a meta-analysis. , 2015, World journal of gastroenterology.

[18]  H. Ogata,et al.  Current status of capsule endoscopy through a whole digestive tract , 2015, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[19]  Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Evidence-Based Analysis. , 2015, Ontario health technology assessment series.

[20]  H. Isomoto,et al.  Endoscopic management of esophagogastric varices in Japan. , 2014, Annals of translational medicine.

[21]  K. Chayama,et al.  Is small‐bowel capsule endoscopy effective for diagnosis of esophagogastric lesions related to portal hypertension? , 2014, Journal of gastroenterology and hepatology.

[22]  T. Hibi,et al.  Use of capsule endoscopy in patients with Crohn's disease in Japan: A multicenter survey , 2014, Journal of gastroenterology and hepatology.

[23]  K. Chayama,et al.  Small Bowel Abnormalities in Patients with Compensated Liver Cirrhosis , 2012, Digestive Diseases and Sciences.

[24]  P. Hayes,et al.  Update of endoscopy in liver disease: more than just treating varices. , 2012, World journal of gastroenterology.

[25]  D. Rockey,et al.  Portal hypertensive gastropathy: a review , 2010, Liver international : official journal of the International Association for the Study of the Liver.

[26]  I. Gralnek,et al.  Capsule endoscopy of the esophagus. , 2009, Journal of clinical gastroenterology.

[27]  Paula R. S. Camara,et al.  Pathogenesis of portal hypertensive gastropathy: translating basic research into clinical practice , 2009, Nature Clinical Practice Gastroenterology &Hepatology.

[28]  A. Sanyal,et al.  Portal hypertension and variceal hemorrhage. , 2008, The Medical clinics of North America.

[29]  L. Laine,et al.  Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension , 2008, Hepatology.

[30]  E. Rondonotti,et al.  Portal hypertensive enteropathy. , 2006, Gastrointestinal endoscopy clinics of North America.

[31]  G. D. De Palma,et al.  Mucosal abnormalities of the small bowel in patients with cirrhosis and portal hypertension: a capsule endoscopy study. , 2005, Gastrointestinal endoscopy.

[32]  C. Gostout,et al.  Portal hypertensive intestinal vasculopathy: a review of the clinical, endoscopic, and histopathologic features. , 1992, The American journal of gastroenterology.

[33]  R. Kozarek,et al.  Portal colopathy: prospective study of colonoscopy in patients with portal hypertension. , 1991, Gastroenterology.

[34]  R. AlvesJde [PORTAL HYPERTENSION]. , 1963, Hospital.