Small bowel capsule endoscopy: Where are we after almost 15 years of use?

Table 2 Comparison of different diagnostic modalities in obscure gastrointestinal bleeding

Ref.	Country	Design	No. of patients	Comparator	Yield of CE, (%)	Yield of Comparator, (%)	Significant difference? (yes/no)	CE superior? (yes/no)	Other
Triester et al[80]	United States	Meta-analysis and Systematic review	396	PE	63	28	Yes	Yes	NNT = 3 to yield one additional clinically significant finding with CE
			88	SB radiography (barium contrast and enteroclysis)	67	8	Yes	Yes	NNT = 3 to yield one additional clinically significant finding with CE
Leighton et al[82]	United States	Meta-analysis and Systematic review	396	PE	63	28	Yes	Yes	Yield of significant findings: CE = 56% vs PE = 26%, NNT = 3 to yield one additional clinically significant finding with CE
			88	Barium radiography	67	8	Yes	Yes	Yield of significant findings: CE = 42% vs SB barium radiography = 6%, NNT = 3 to yield one additional clinically significant finding with CE
			42	Intraoperative enteroscopy	83	83	No	No
			17	Mesenteric angiography	47	53	No	No
Chen et al[205]	China	Meta-analysis and Systematic review	277	DBE	61	56	No	No	CE was superior if no combination of oral + anal approach <-> DBE was superior when a combination of the two insertion approaches was done
Pasha et al[95]	United States	Meta-analysis and Systematic review	397	DBE	24	24	No	No	CE should be the initial diagnostic test for determining insertion route of DBE
Arakawa et al[76]	Japan	Retrospective Study	162	DBE	54	64	No	No
Teshima et al[77]	Canada, The Netherlands	Meta-analysis and Systematic review	651	DBE	62	56	No	Yes	Yield of DBE after positive CE = 75.0% <-> yield after negative CE = 27.5%
Leung et al[206]	China	RCT	60	Mesenteric angiography	53	20	Yes	Yes	No significant difference in the long-term outcomes (transfusion need, hospitalization for rebleeding,mortality)
Wang et al[207]	China	Meta-analysis and Systematic review	279	CT	53	34	Yes	Yes	Complementary role to CE and can be used as a triage tool prior to DBE in evaluating OGIB

PE: Push enteroscopy; CE: Capsule endoscopy; SB: Small bowel; NNT: Number needed to treat; DBE: Double balloon enteroscopy; RCT: Randomized controlled trial.