Supplementary Material for: Video-capsule endoscopy after bariatric surgery: a tertiary referral center experience

Background and aim: Minimal data is available regarding the performance of video capsule endoscopy (VCE) in patients that underwent bariatric surgery. We aim to report indications, feasibility and safety of VCE performed after bariatric surgery, specifically focusing on diagnosis rates of Crohn’s disease (CD) in this population. Methods: A retrospective analysis of all VCE procedures performed between January 2015 to December 2019. All patients that underwent bariatric surgery prior to VCE were included. Indication for VCE, Ingestion methods, completion rates, retention rates, and endoscopic findings were recorded. Results: A total of 1255 patients underwent VCE examination during the study period, of which 31 (2.5%) underwent bariatric surgery prior to VCE. The most common bariatric surgery was laparoscopic sleeve gastrectomy (16 patients, 51.6%) and the most common indication for VCE was evaluation of iron deficiency anemia (14 patients, 45.1%). The majority of patient ingested the capsule independently, without endoscopic assistance (20, 64.5%). Although patency capsule was not used in our cohort, no events of capsule retention were documented. Mean transit time was 4.32 hours. Only 4 events of incomplete examination were recorded. Over a median follow up of 27.5 months (IQR 13.0-34.2) 10 patients (31.2%) had a final diagnosis of CD with a median Lewis score of 225 (IQR 135-900). Conclusion: VCE is a feasible and safe procedure after bariatric surgery. Oral ingestion does not carry risk of retention. It is an effective means of diagnosis of small bowel CD in this population.背景与研究目的：目前关于减肥手术患者应用视频胶囊内镜（video capsule endoscopy, VCE）的诊疗效能相关数据极少。本研究旨在报告减肥手术后行VCE的适应证、可行性与安全性，并重点分析该人群中克罗恩病（Crohn’s disease, CD）的诊断率。 方法：对2015年1月至2019年12月期间开展的所有VCE操作进行回顾性分析。纳入所有在VCE术前接受过减肥手术的患者，记录VCE的检查适应证、胶囊吞服方式、检查完成率、胶囊滞留率及内镜下表现。 结果：本研究期间共计1255例患者接受VCE检查，其中31例（2.5%）在VCE术前接受过减肥手术。最常见的减肥手术方式为腹腔镜袖状胃切除术（16例，占51.6%），最常见的VCE检查适应证为缺铁性贫血评估（14例，占45.1%）。多数患者可自行吞服胶囊，无需内镜辅助（20例，占64.5%）。尽管本队列未使用通畅性胶囊，但未记录到任何胶囊滞留事件。平均通过时间为4.32小时，仅记录到4例检查未完成的情况。中位随访时长为27.5个月（四分位距13.0~34.2），其中10例（31.2%）最终确诊为克罗恩病，中位Lewis评分为225（四分位距135~900）。 结论：减肥手术后行VCE是一项可行且安全的检查手段，口服吞服胶囊无滞留风险，该检查可有效诊断该人群的小肠克罗恩病。