Abstract
Background and aim : Strategies for diagnosis and treatment of small bowel diseases improved drastically between 2000 and 2001, when capsule endoscopy (CE) and double-balloon endoscopy (DBE) were commercially introduced. However, the current situation of the spread and clinical practice of these new modalities have not been well elucidated in Gunma prefecture. Our study aim was to clarify the current status of endoscopic diagnosis and treatment of small bowel diseases in our department and its affiliated hospitals.
Methods : We evaluated the current status of institutions that own DBE, CE or single-balloon endoscopy (SBE) in all hospitals in Gunma prefecture, as well as treatment data of DBE and CE in our department and its affiliated hospitals as of April 2012. We also evaluated the current situation of the CE network (CEN) established in 2009 in our department and its affiliated hospitals.
Results : Although institutions that own CE, DBE or SBE were unevenly distributed in Gunma prefecture, the numbers of such institutions have been increasing. Furthermore, the rental of these modalities has also been increasing. Evaluation for obscure gastrointestinal bleeding (OGIB) made up two-thirds of the use of DBE. An unusual event was onecase (0.5%) of pancreatitis. In contrast, evaluation of OGIB made up three quarters of CE utility. Capsule retention occurred in three patients and subsequently, two patients required DBE and one required surgery to retrieve the capsules. In general, the results of diagnosis and treatment of these modalities were comparable to those in previous reports. In the CEN system, the original workflow is active and currently Gunma University also functions as the institution advising affiliated hospitals about medical care of small bowel diseases, accepting patients referred from these hospitals, or educating endoscopists in these hospitals about interpretation of CE.
Conclusions : New modalities for diagnosis and treatment of small bowel diseases have been widespread in Gunma prefecture and medical standards in this field have been improving in our department and its affiliated hospitals.
