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 24 January 2018

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News

Noninvasive alternative to upper endoscopy for esophageal varices

PillCam ESO may represent an accurate noninvasive alternative to conventional upper endoscopy for the detection of esophageal varices and portal hypertensive gastropathy, finds this month's Endoscopy.

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Variceal bleeding is a major complication of cirrhosis, and is associated with a 20% mortality at 6 weeks.

Current international guidelines recommend that patients with cirrhosis are screened by conventional upper endoscopy in order to detect esophageal varices.

The PillCam ESO esophageal capsule endoscope has been shown to be an accurate diagnostic tool for gastroesophageal reflux and Barrett's esophagus.

Dr Eisen and colleagues from Italy compared the PillCam ESO capsule endoscope with conventional upper endoscopy.

The researchers assessed whether this technique detects esophagogastric varices and portal hypertensive gastropathy in patients with cirrhosis.

The research team conducted a pilot trial at 3 sites.

The team included patients with cirrhosis undergoing clinically indicated conventional endoscopy for screening or surveillance for esophageal varices.

The patients underwent a PillCam ESO study followed by conventional upper endoscopy within 48 hours.

The overall concordance between the methods was 97% for the diagnosis of esophageal varices
Endoscopy

Capsule videos were assessed by an investigator who was blinded to the patient's medical history and endoscopy findings.

A total of 23 of the 32 enrolled patients were found to have esophageal varices using both endoscopy techniques.

In 1 patient, PillCam ESO detected small varices that were not seen at conventional endoscopy.

The team noted that the overall concordance between PillCam ESO and conventional endoscopy was 97% for the diagnosis of esophageal varices.

The researchers observed a 91% concordance between PillCam ESO and conventional endoscopy for the diagnosis of portal hypertensive gastropathy.

There were no adverse events related to PillCam ESO endoscopy.

Dr Eisen's team commented, “In a high-prevalence population, PillCam ESO may represent an accurate noninvasive alternative to conventional upper endoscopy for the detection of esophageal varices and portal hypertensive gastropathy.”

“A large-scale trial is underway to validate and expand these findings.”

Endoscopy 2006: 38: 31-5
03 February 2006

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