VCE retention occurs in approximately 2% of patients undergoing evaluation for small-bowel bleeding and is most likely due to small-bowel strictures. The most common reasons for retention were small-bowel strictures, although etiology was not provided in all studies. Reasons for retention were provided in 60 (77%) studies. Based on subgroup analysis, subsequent VCE completion rates after performance of a patency capsule or CT enterography in patients with IBD to exclude retentions due to strictures was 2.7% (95% CI, 1.1%-6.4%). We used a random effects model and found that the pooled retention rate was 2.1% for patients with suspected small-bowel bleeding (95% CI, 1.5%-2.8%).
We included 25 studies (N = 5876) for patients undergoing VCE for evaluation of potential small-bowel bleeding, 9 studies (N = 968) for patients with suspected inflammatory bowel disease (IBD), 11 studies (N = 558) for patients with established IBD, and 8 studies for patients (N = 111) undergoing VCE for evaluation of abdominal pain and/or diarrhea. We used Comprehensive Meta-Analysis (Version 3.0) to calculate pooled prevalence rates with 95% confidence intervals (CIs) and assessed heterogeneity by using the Cochran Q statistic. We included studies that enrolled at least 10 patients, included VCE retention rates, and separated retention rates by indication. We performed a systematic review of VCE retention rates by using Pubmed and SCOPUS (1995-2015). However, retention of the video capsule endoscope remains a major concern. Video capsule endoscopy (VCE) has become a major diagnostic tool for small-bowel evaluation.
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