中華醫(yī)學(xué)會(huì)消化內(nèi)鏡學(xué)分會(huì)

中華醫(yī)學(xué)會(huì)消化內(nèi)鏡學(xué)分會(huì)膠囊內(nèi)鏡和小腸鏡學(xué)組于2008年制訂了《中華消化內(nèi)鏡學(xué)會(huì)膠囊內(nèi)鏡臨床應(yīng)用規(guī)范》，對(duì)我國(guó)規(guī)范使用膠囊內(nèi)鏡提供了有力參考。膠囊內(nèi)鏡檢查歷經(jīng)10余年的發(fā)展，已經(jīng)成為重要的消化道疾病檢查手段，尤其是對(duì)小腸疾病的診斷。隨著科學(xué)技術(shù)的不斷進(jìn)步，除小腸膠囊內(nèi)鏡出現(xiàn)部分改進(jìn)外，食管專用膠囊內(nèi)鏡、結(jié)腸專用膠囊內(nèi)鏡以及專用磁控膠囊胃鏡亦已進(jìn)入臨床應(yīng)用階段。因此，膠囊內(nèi)鏡和小腸鏡學(xué)組決定與時(shí)俱進(jìn)，更新和完善相關(guān)規(guī)范，在經(jīng)過專家廣泛討論和多次修改后，現(xiàn)更新我國(guó)膠囊內(nèi)鏡臨床應(yīng)用指南如下。

一、檢查前準(zhǔn)備、膠囊內(nèi)鏡檢查

(一)檢查前準(zhǔn)備

鑒于膠囊內(nèi)鏡檢查可能發(fā)生膠囊滯留和診斷的不確定性，檢查前應(yīng)對(duì)患者予以告知并簽署知情同意書。由于全國(guó)各地區(qū)膠囊內(nèi)鏡檢查水平發(fā)展不均衡，現(xiàn)附統(tǒng)一知情同意書標(biāo)準(zhǔn)模板以規(guī)避可能出現(xiàn)的相關(guān)檢查風(fēng)險(xiǎn)(附錄一)。

小腸膠囊內(nèi)鏡檢查[1-7]：

1. 檢查前需禁食或進(jìn)清流質(zhì)10～12 h；

2. 檢查前夜行腸道清潔準(zhǔn)備(參考相關(guān)內(nèi)鏡檢查腸道準(zhǔn)備指南)；

3. 術(shù)前半小時(shí)服用適量祛泡劑，以減少泡沫對(duì)視野的影響；

4. 不推薦使用促胃腸動(dòng)力藥。目前研究尚不支持促動(dòng)力藥能夠幫助提高全小腸檢查完成率。

食管專用膠囊內(nèi)鏡檢查[8-9]：

1. 檢查前禁食2 h；

2. 飲用少量水(約10 mL)幫助膠囊內(nèi)鏡吞服；

3. 檢查過程中患者取仰臥位，或可采用5分鐘法：吞服膠囊后2 min取仰臥位，繼2 min 30°半臥位，繼1 min 60°半臥位，繼以15 min坐位。

結(jié)腸專用膠囊內(nèi)鏡檢查[9-13]：

1. 檢查前1日進(jìn)清流質(zhì)飲食；

2. 檢查前夜行腸道清潔準(zhǔn)備(參考相關(guān)內(nèi)鏡檢查腸道準(zhǔn)備指南)；

3. 檢查過程中加服小劑量磷酸鈉溶液(45～55 mL)，通過增加腸蠕動(dòng)使膠囊盡早進(jìn)入結(jié)腸(使用方法和禁忌證參照相關(guān)指南)；

4. 吞服膠囊后1 h膠囊尚未通過幽門者，建議給予促胃腸動(dòng)力藥或經(jīng)胃鏡將膠囊送入十二指腸以縮短膠囊在胃內(nèi)的停留時(shí)間。

胃專用膠囊內(nèi)鏡檢查：

初步臨床研究結(jié)果顯示，對(duì)胃各部分顯示率達(dá)85%，診斷準(zhǔn)確率為90%以上，有望在臨床推廣應(yīng)用。

(二)膠囊內(nèi)鏡檢查操作過程

檢查時(shí)將數(shù)據(jù)記錄儀通過導(dǎo)線與粘貼于患者腹部體表的陣列傳感器電極相連或穿戴記錄儀背心?；颊咄谭z囊后，按時(shí)記錄相關(guān)癥狀并監(jiān)視數(shù)據(jù)記錄儀上閃爍的指示燈，以確定檢查設(shè)備的正常運(yùn)行。檢查期間避免劇烈運(yùn)動(dòng)和進(jìn)入強(qiáng)磁場(chǎng)區(qū)域，以防圖像信號(hào)受到干擾。服用膠囊2 h后可飲清水，4 h后可進(jìn)少許清淡食物。在膠囊電池耗盡時(shí)或膠囊經(jīng)回盲瓣進(jìn)入結(jié)腸(小腸膠囊內(nèi)鏡)或自肛門排出體外(結(jié)腸膠囊內(nèi)鏡)后將數(shù)據(jù)記錄儀從患者身上取下，并連接至可進(jìn)行數(shù)據(jù)處理的工作站。數(shù)據(jù)記錄儀中的圖像資料最終下載至工作站中，并由相關(guān)軟件進(jìn)行處理。讀片中典型圖片和視頻可被單獨(dú)注釋和保存。工作站具有顯示膠囊走向軌跡的模擬定位功能，對(duì)幫助小腸內(nèi)病灶的定位有一定參考意義。詳細(xì)檢查方法見相關(guān)產(chǎn)品說明書。

二、適應(yīng)證和禁忌證

(一)小腸膠囊內(nèi)鏡檢查主要適應(yīng)證[9,11,13]

1. 不明原因消化道出血；

2. 不明原因缺鐵性貧血；

3. 疑似克羅恩病或監(jiān)測(cè)并指導(dǎo)克羅恩病治療；

4. 疑似小腸腫瘤；

5. 監(jiān)測(cè)小腸息肉病綜合征的發(fā)展；

6. 疑似或難以控制的吸收不良綜合征(如乳糜瀉等)；

7. 檢測(cè)非甾體消炎藥相關(guān)性小腸黏膜損害；

8. 臨床上需要排除小腸疾病者。

(二)食管專用膠囊內(nèi)鏡檢查主要適應(yīng)證[8-9,13]

1. 疑似Barrett食管；

2. 疑似食管炎；

3. 疑似食管靜脈曲張；

4. 需要接受食管內(nèi)鏡檢查，但不愿接受或不能耐受胃食管鏡檢查者。

(三)結(jié)腸專用膠囊內(nèi)鏡檢查主要適應(yīng)證[9-10,12]

1. 需要接受結(jié)腸鏡檢查，但不能耐受或條件不允許者；

2. 結(jié)腸鏡檢查無法到達(dá)回盲瓣，同時(shí)無消化道梗阻者；

3. 潰瘍性結(jié)腸炎的隨訪，以指導(dǎo)治療；

4. 普通人群的結(jié)腸病變篩查。

(四)膠囊內(nèi)鏡檢查禁忌證[9-13]

1. 絕對(duì)禁忌證：無手術(shù)條件或拒絕接受任何腹部手術(shù)者(一旦膠囊滯留將無法通過手術(shù)取出)；

2. 相對(duì)禁忌證：①已知或懷疑胃腸道梗阻、狹窄以及瘺管；②心臟起搏器或其他電子儀器植入者；③吞咽障礙者；④妊娠期婦女。

三、膠囊內(nèi)鏡對(duì)疾病的診斷

(一)小腸膠囊內(nèi)鏡

1. 不明原因消化道出血[14-30]：膠囊內(nèi)鏡對(duì)不明原因消化道出血的總體診斷率為35%～77%，出血診斷率的高低與出血狀況密切相關(guān)，顯性出血和隱性出血的診斷率分別為92%和44%，但對(duì)既往有出血史而近期無出血患者的診斷率僅為13%，因此膠囊內(nèi)鏡的最佳檢查時(shí)機(jī)為出血?jiǎng)偼Ｖ箶?shù)天至2周內(nèi)。與術(shù)中小腸鏡的比較結(jié)果顯示膠囊內(nèi)鏡對(duì)不明原因消化道出血診斷的敏感性、特異性、陽(yáng)性預(yù)測(cè)值和陰性預(yù)測(cè)值分別為95%、75%、95%和86%。與氣囊式小腸鏡相比，總體診斷率相似，但膠囊內(nèi)鏡對(duì)血管病變和炎癥性病灶更敏感且依從性更好，使膠囊內(nèi)鏡成為不明原因消化道出血的一線檢查手段，有助于臨床決策。

最常見的小腸出血病因?yàn)檠懿∽?，其次為克羅恩病和小腸腫瘤。

2. 小腸血管病變：包括小腸動(dòng)靜脈畸形、毛細(xì)血管擴(kuò)張癥、靜脈擴(kuò)張癥等。主要表現(xiàn)為血管成叢簇樣，黏膜表面見局灶紅斑，血管分布錯(cuò)亂，血管擴(kuò)張明顯高出黏膜面等。其主要臨床表現(xiàn)為不明原因消化道出血。

3. 克羅恩病[31-37]：膠囊內(nèi)鏡可用于小腸克羅恩病的初次診斷、監(jiān)測(cè)疾病的復(fù)發(fā)、明確病變的范圍和嚴(yán)重程度、評(píng)估藥物、手術(shù)治療療效。膠囊內(nèi)鏡對(duì)克羅恩病的診斷率為43%～77%，優(yōu)于小腸鋇灌、CT小腸重建、MRI小腸重建、結(jié)腸鏡逆行回腸檢查。診斷敏感性可達(dá)90%。

克羅恩病的膠囊內(nèi)鏡下表現(xiàn)主要為小腸絨毛缺失、黏膜充血水腫、黏膜糜爛、口瘡樣潰瘍、縱行潰瘍、卵石征、肉芽腫樣改變、腸管狹窄、瘺管、多發(fā)假性息肉等，病變多呈跳躍式分布。但克羅恩病的診斷應(yīng)是綜合性的，影像學(xué)檢查需與病史和其他檢查結(jié)合分析，部分患者可行氣囊輔助式小腸鏡輔以活檢病理等檢查予以佐證。

4. 小腸腫瘤[38-42]：小腸腫瘤大多見于因其他指征而行膠囊內(nèi)鏡的檢查中，盡管膠囊內(nèi)鏡的發(fā)現(xiàn)率高于CT檢查，但仍存在約19%的漏診率。最常見的臨床表現(xiàn)為不明原因消化道出血或貧血(占80%)。小腸惡性腫瘤包括間質(zhì)瘤、腺癌、類癌、黑色素瘤、淋巴瘤以及肉瘤等；良性腫瘤包括血管瘤、錯(cuò)構(gòu)瘤、腺瘤等。

(1)小腸腺癌：小腸腺癌以位于十二指腸降段和Treitz韌帶附近居多，空、回腸相對(duì)較少。腺癌病灶常呈隆起增殖型，多伴腸腔狹窄，病灶表面高低不平，結(jié)節(jié)或菜花狀，表面質(zhì)脆易出血，部分呈潰瘍狀，病變邊界清晰可辨。

(2)小腸間質(zhì)瘤：小腸間質(zhì)瘤是最常見的小腸間葉來源腫瘤，占消化道間質(zhì)瘤的30%，直徑<2 cm 被稱為小間質(zhì)瘤。約30%的間質(zhì)瘤表現(xiàn)出轉(zhuǎn)移、浸潤(rùn)等惡性生物學(xué)行為；約1/3可合并出血。膠囊內(nèi)鏡下小腸間質(zhì)瘤主要表現(xiàn)為隆起或半球狀，表面光滑，病灶中央可出現(xiàn)潰瘍或潰爛，有時(shí)可見新鮮或陳舊血痂，部分可見裸露血管。

5. 遺傳性息肉病綜合征[43-48]：膠囊內(nèi)鏡作為一項(xiàng)無創(chuàng)檢查，在非家族性腺瘤性息肉病、非Peutz-Jeghers綜合征患者中，息肉檢出率顯著高于MRI小腸重建，尤其對(duì)直徑<5 mm的息肉更具優(yōu)勢(shì)。

對(duì)于家族性腺瘤性息肉病和Peutz-Jeghers綜合征等遺傳性息肉病的患者來說，由于需要定期隨訪和監(jiān)測(cè)，則膠囊內(nèi)鏡更具優(yōu)勢(shì)。氣囊輔助式小腸鏡在檢出率方面優(yōu)于膠囊內(nèi)鏡，但膠囊內(nèi)鏡依從性更好。

6. 吸收不良綜合征(如乳糜瀉)[49]：膠囊內(nèi)鏡下的特征性表現(xiàn)為小腸黏膜自身改變，即絨毛萎縮(扇貝樣、裂隙狀、馬賽克型、環(huán)狀皺襞消失以及結(jié)節(jié)樣改變等)以及與其并發(fā)癥相關(guān)的表現(xiàn)，如潰瘍性空腸炎、腸病相關(guān)性T細(xì)胞淋巴瘤、小腸腺癌等。膠囊內(nèi)鏡診斷乳糜瀉的敏感性和特異性分別達(dá)到89%和95%。小腸吸收不良綜合征病因眾多，診斷應(yīng)結(jié)合病史和血清學(xué)檢查等，小腸鏡下分段多點(diǎn)活檢有助于病理診斷，膠囊內(nèi)鏡則有助于復(fù)雜乳糜瀉的診斷。

7. 非甾體消炎藥相關(guān)性小腸黏膜損害[50]：研究顯示膠囊內(nèi)鏡對(duì)非甾體消炎藥相關(guān)性小腸黏膜受損的診斷率可高達(dá)68%。最常見的非甾體消炎藥相關(guān)性小腸黏膜病變?yōu)轲つて茡p、皺襞發(fā)紅、斑點(diǎn)狀黏膜出血、潰瘍以及腸隔膜形成等。

8. 其他[9]：膠囊內(nèi)鏡還有助于一些少見小腸疾病的診斷，如小腸憩室表現(xiàn)為黏膜上孔狀圓形洞穴，周邊黏膜光整柔軟，Meckel憩室通常表現(xiàn)為廣口或窄口的大憩室；其次為結(jié)核、寄生蟲、放射性腸炎等。膠囊內(nèi)鏡還可用于對(duì)胃腸動(dòng)力障礙性疾病的研究、評(píng)估小腸移植術(shù)后的改變以及對(duì)不明原因腹痛和腹瀉的診斷等。

(二)食管專用膠囊內(nèi)鏡[51-86]

食管專用膠囊內(nèi)鏡診斷Barrett食管的敏感性約為77%，特異性約為86%；診斷食管炎的敏感性為50%～79%，特異性約為90%；診斷食管靜脈曲張的敏感性為82.7%，特異性為80.5%。以上結(jié)果均不及普通上消化道內(nèi)鏡，其優(yōu)勢(shì)在于良好的依從性。

(三)結(jié)腸專用膠囊內(nèi)鏡[87-112]

結(jié)腸專用膠囊內(nèi)鏡診斷明顯結(jié)腸病變(≥6 mm或≥3個(gè)獨(dú)立的息肉)的敏感性約為58%～86%。值得注意的是，膠囊內(nèi)鏡診斷息肉的特異性較低，容易高估小息肉的大小，但總體不影響結(jié)腸膠囊內(nèi)鏡對(duì)結(jié)腸息肉的篩查。

炎癥性腸病大多累及結(jié)直腸黏膜，約70%～80%的克羅恩病和幾乎全部的潰瘍性結(jié)腸炎可在結(jié)直腸發(fā)現(xiàn)病灶。目前研究表明，結(jié)腸膠囊內(nèi)鏡可用于監(jiān)測(cè)潰瘍性結(jié)腸炎的活動(dòng)性和評(píng)估療效。但目前尚無充足證據(jù)支持結(jié)腸膠囊內(nèi)鏡可用于確診可疑的炎癥性腸病，這部分患者仍應(yīng)選擇常規(guī)結(jié)腸鏡檢查。

對(duì)于結(jié)直腸癌高?；颊?，結(jié)腸膠囊內(nèi)鏡的特異性較高，但存在敏感性低和膠囊滯留增加的風(fēng)險(xiǎn)。因此，對(duì)于存在報(bào)警癥狀的結(jié)直腸癌高危患者，應(yīng)接受常規(guī)結(jié)直腸鏡檢查，結(jié)腸膠囊內(nèi)鏡檢查不作為首選方法。

四、膠囊內(nèi)鏡檢查的并發(fā)癥[113-120]

膠囊內(nèi)鏡檢查的并發(fā)癥包括：膠囊滯留、誤吸入氣管等。

膠囊內(nèi)鏡檢查后膠囊停留于胃腸道達(dá)2周以上則定義為膠囊滯留。滯留主要發(fā)生于克羅恩病和易導(dǎo)致狹窄的高危疾病，如服用非甾體消炎藥、缺血性腸炎、小腸腫瘤、放射性腸炎、腸結(jié)核以及手術(shù)吻合口狹窄等患者。膠囊滯留的總體發(fā)生率為1.3%～1.4%，在不明原因消化道出血、克羅恩病、腫瘤性病變患者中，滯留率分別為1.2%、2.6%和2.1%。腹部X線攝片檢查能幫助確定膠囊是否排出。滯留的膠囊可通過外科手術(shù)和氣囊輔助式小腸鏡予以取出。有因膠囊滯留而造成腸道梗阻甚至穿孔以及因膠囊誤吸入氣管導(dǎo)致窒息的個(gè)案報(bào)道。對(duì)于已知或懷疑胃腸道梗阻、狹窄、瘺管者進(jìn)行膠囊內(nèi)鏡檢查需十分慎重，應(yīng)在充分告知以及作好手術(shù)前準(zhǔn)備的情況下完成檢查。

五、膠囊內(nèi)鏡檢查的局限性

目前無任何有關(guān)膠囊內(nèi)鏡造成電子設(shè)備(如心臟起搏器等)失效的報(bào)道[121-126]，但膠囊接近起搏器時(shí)存在內(nèi)鏡影像部分缺失的現(xiàn)象。在膠囊內(nèi)鏡檢查以及膠囊尚未排出體外時(shí)，不能接受MRI檢查。

非操控式膠囊的運(yùn)行依賴胃腸道的自身蠕動(dòng)，可能會(huì)影響膠囊觀察視角的精準(zhǔn)度，而非360°角度的視野可能存在拍攝盲區(qū)，易導(dǎo)致假陰性結(jié)果。

六、膠囊內(nèi)鏡輔助輸送裝置

多種附件可用于對(duì)吞咽困難、胃輕癱、已知或懷疑上消化道解剖結(jié)構(gòu)異常者的膠囊輸送，應(yīng)用外套管可將膠囊送入胃內(nèi)；應(yīng)用圈套器或網(wǎng)籃可將膠囊送入十二指腸和胃畢Ⅱ式手術(shù)后的輸出袢。輔助輸送裝置的臨床應(yīng)用將有助于完成特殊患者的膠囊內(nèi)鏡檢查[127]。

七、膠囊內(nèi)鏡報(bào)告書寫的規(guī)范格式

膠囊內(nèi)鏡標(biāo)準(zhǔn)報(bào)告書寫系統(tǒng)應(yīng)由兩部分組成，即報(bào)告框架和報(bào)告內(nèi)容。

(一)報(bào)告框架(基本資料和信息)

報(bào)告框架應(yīng)盡可能按各單位習(xí)慣和相關(guān)專業(yè)指南標(biāo)準(zhǔn)設(shè)計(jì)，如：患者姓名、出生年月、性別、病例號(hào)、檢查日期、檢查類型(膠囊型號(hào))、膠囊編號(hào)、操作醫(yī)師、病史、臨床指征、檢查范圍、病變描述、并發(fā)癥、檢查結(jié)果、診斷印象、建議等。

(二)報(bào)告內(nèi)容

消化道黏膜有其顏色特征，包括紅斑、白色和蒼白等。每個(gè)病灶可由解剖位置或膠囊運(yùn)行時(shí)間來定位，每種病變類型均作為一個(gè)單項(xiàng)進(jìn)行觀察和描述，具體病變描述內(nèi)容與標(biāo)準(zhǔn)內(nèi)鏡相似。但由于對(duì)小腸病變的描述有其特殊性，建議參照膠囊內(nèi)鏡標(biāo)準(zhǔn)術(shù)語使用規(guī)范(附錄二)。此外，還應(yīng)注明膠囊工作時(shí)間以及通過食管、胃和小腸的時(shí)間。

八、膠囊內(nèi)鏡標(biāo)準(zhǔn)術(shù)語使用規(guī)范(附錄二)

參與討論專家(按姓氏筆畫排序)：

戈之錚(上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院消化科)、王邦茂(天津大學(xué)總醫(yī)院消化科)、厲有名(浙江大學(xué)附屬第一醫(yī)院消化科)、令狐恩強(qiáng)(中國(guó)人民解放軍總醫(yī)院消化科)、李兆申(第二軍醫(yī)大學(xué)附屬長(zhǎng)海醫(yī)院消化科)、陸星華(北京協(xié)和醫(yī)院消化科)、金震東(第二軍醫(yī)大學(xué)附屬長(zhǎng)海醫(yī)院消化科)、項(xiàng)平(復(fù)旦大學(xué)附屬華東醫(yī)院消化科)、趙曉晏(第三軍醫(yī)大學(xué)新橋醫(yī)院消化科)、鐘捷(上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院消化科)、徐肇敏(南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院消化科)、智發(fā)朝(南方醫(yī)科大學(xué)南方醫(yī)院消化科)、廖專(第二軍醫(yī)大學(xué)附屬長(zhǎng)海醫(yī)院消化科)

1 Ben-Soussan E, Savoye G, Antonietti M, et al. Is a 2-liter PEG preparation useful before capsule endoscopy?[J]. J Clin Gastroenterol, 2005, 39 (5): 381-384.

2 Wei W, Ge ZZ, Lu H, et al. Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging[J]. Am J Gastroenterol, 2008, 103 (1): 77-82.

3 Dai N, Gubler C, Hengstler P, et al. Improved capsule endoscopy after bowel preparation[J]. Gastrointest Endosc, 2005, 61 (1): 28-31.

4 de Franchis R, Avgerinos A, Barkin J, et al. ICCE consensus for bowel preparation and prokinetics[J]. Endoscopy, 2005, 37 (10): 1040-1045.

5 Ge ZZ, Chen HY, Gao YJ, et al. The role of simeticone in small-bowel preparation for capsule endoscopy[J]. Endoscopy, 2006, 38 (8): 836-840.

6 Chen HB, Huang Y, Chen SY, et al. Small bowel preparations for capsule endoscopy with mannitol and simethicone: a prospective, randomized, clinical trial[J]. J Clin Gastroenterol, 2011, 45 (4): 337-341.

7 Ito T, Ohata K, Ono A, et al. Prospective controlled study on the effects of polyethylene glycol in capsule endoscopy[J]. World J Gastroenterol, 2012, 18 (15): 1789-1792.

8 Sharma VK, Eliakim R, Sharma P, et al. ICCE con-sensus for esophageal capsule endoscopy[J]. Endoscopy, 2005, 37 (10): 1060-1064.

9 Ladas SD, Triantafyllou K, Spada C, et al. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases[J]. Endoscopy, 2010, 42 (3): 220-227.

10 Spada C, Hassan C, Galmiche JP, et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline[J]. Endoscopy, 2012, 44 (5): 527-536.

11 Sidhu R, Sanders DS, Morris AJ, et al. Guidelines on small bowel enteroscopy and capsule endoscopy in adults[J]. Gut, 2008, 57 (1): 125-136.

12 ASGE Technology Committee; Adler DG, Chand B, Conway JD, et al. Capsule endoscopy of the colon[J]. Gastrointest Endosc, 2008, 68 (4): 621-623.

13 ASGE Technology Committee; Wang A, Banerjee S, Barth BA, et al. Wireless capsule endoscopy[J]. Gastrointest Endosc, 2013, 78 (6): 805-815.

14 Ge ZZ, Chen HY, Gao YJ, et al. Best candidates for capsule endoscopy for obscure gastrointestinal bleeding[J]. J Gastroenterol Hepatol, 2007, 22 (12): 2076-2080.

15 Spada C, Riccioni ME, Hassan C, et al. PillCam colon capsule endoscopy: a prospective, randomized trial comparing two regimens of preparation[J]. J Clin Gastroenterol, 2011, 45 (2): 119-124.

16 Estevez E, Gonzalez-Conde B, Vazquez-Iglesias JL, et al. Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding[J]. Eur J Gastroenterol Hepatol, 2006, 18 (8): 881-888.

17 Lecleire S, Iwanicki-Caron I, Di-Fiore A, et al. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding[J]. Endoscopy, 2012, 44 (4): 337-342.

18 Robinson CA, Jackson C, Condon D, et al. Impact of inpatient status and gender on small-bowel capsule endoscopy findings[J]. Gastrointest Endosc, 2011, 74 (5): 1061-1066.

19 van Turenhout ST, Jacobs MA, van Weyenberg SJ, et al. Diagnostic yield of capsule endoscopy in a tertiary hospital in patients with obscure gastrointestinal bleeding[J]. J Gastrointestin Liver Dis, 2010, 19 (2): 141-145.

20 Sidhu R, Sanders DS, Kapur K, et al. Factors predicting the diagnostic yield and intervention in obscure gastrointestinal bleeding investigated using capsule endoscopy[J]. J Gastrointestin Liver Dis, 2009, 18 (3): 273-278.

21 Albert JG, Schülbe R, Hahn L, et al. Impact of capsule endoscopy on outcome in mid-intestinal bleeding: a multicentre cohort study in 285 patients[J]. Eur J Gastroenterol Hepatol, 2008, 20 (1): 971-977.

22 Esaki M, Matsumoto T, Yada S, et al. Factors associated with the clinical impact of capsule endoscopy in patients with overt obscure gastrointestinal bleeding[J]. Dig Dis Sci, 2010, 55 (8): 2294-2301.

23 Lepileur L, Dray X, Antonietti M, et al. Factors as-sociated with diagnosis of obscure gastrointestinal bleeding by video capsule enteroscopy[J]. Clin Gastroenterol Hepatol, 2012, 10 (12): 1376-1380.

24 Hartmann D, Schmidt H, Bolz G, et al. A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding[J]. Gastrointest Endosc, 2005, 61 (7): 826-832.

25 Marmo R, Rotondano G, Casetti T, et al. Degree of concordance between double-balloon enteroscopy and capsule endoscopy in obscure gastrointestinal bleeding: a multicenter study[J]. Endoscopy, 2009, 41 (7): 587-592.

26 Chen X, Ran ZH, Tong JL. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases[J]. World J Gastroenterol, 2007, 13 (32): 4372-4378.

27 Pasha SF, Leighton JA, Das A, et al. Double-balloon enteroscopy and capsule endoscopy have comparable diagnostic yield in small-bowel disease: a meta-analysis[J]. Clin Gastroenterol Hepatol, 2008, 6 (6): 671-676.

28 Teshima CW, Kuipers EJ, van Zanten SV, et al. Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding: an updated meta-analysis[J]. J Gastroenterol Hepatol, 2011, 26 (5): 796-801.

29 Ge ZZ, Hu YB, Xiao SD. Capsule endoscopy and push enteroscopy in the diagnosis of obscure gastrointestinal bleeding[J]. Chin Med J (Engl), 2004, 117 (7): 1045-1049.

30 Sidhu R, McAlindon ME, Drew K, et al. Evaluating the role of small-bowel endoscopy in clinical practice: the largest single-centre experience[J]. Eur J Gastroenterol Hepatol, 2012, 24 (5): 513-519.

31 Niv E, Fishman S, Kachman H, et al. Sequential capsule endoscopy of the small bowel for follow-up of patients with known Crohn’s disease[J]. J Crohns Colitis, 2014[Epub ahead of print].

32 Kono T, Hida N, Nogami K, et al. Prospective postsurgical capsule endoscopy in patients with Crohn’s disease[J]. World J Gastrointest Endosc, 2014, 6 (3): 88-98.

33 Esaki M, Matsumoto T, Watanabe K, et al. Use of capsule endoscopy in patients with Crohn’s disease in Japan: a multicenter survey[J]. J Gastroenterol Hepatol, 2014, 29 (1): 96-101.

34 Dubcenco E, Jeejeebhoy KN, Petroniene R, et al. Capsule endoscopy findings in patients with established and suspected small-bowel Crohn’s disease: correlation with radiologic, endoscopic, and histologic findings[J]. Gastrointest Endosc, 2005, 62 (4): 538-544.

35 Flamant M, Trang C, Bourreille A. Wireless capsule in inflammatory bowel disease[J]. Gastroenterol Clin Biol, 2009, 33 Suppl 3: S183-S189.

36 Dionisio PM, Gurudu SR, Leighton JA, et al. Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small-bowel Crohn’s disease: a meta-analysis[J]. Am J Gastroenterol, 2010, 105 (6): 1240-1248.

37 Triester SL, Leighton JA, Leontiadis GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease[J]. Am J Gastroenterol, 2006, 101 (5): 954-964.

38 Riccioni ME, Cianci R, Urgesi R, et al. Advance in diagnosis and treatment of small bowel tumors: a single-center report[J]. Surg Endosc, 2012, 26 (2): 438-441.

39 Zagorowicz ES, Pietrzak AM, Wronska E, et al. Small bowel tumors detected and missed during capsule endoscopy: single center experience[J]. World J Gastroenterol, 2013, 19 (47): 9043-9048.

40 Lewis BS, Eisen GM, Friedman S. A pooled analysis to evaluate results of capsule endoscopy trials[J]. Endoscopy, 2005, 37 (10): 960-965.

41 Postgate A, Despott E, Burling D, et al. Significant small-bowel lesions detected by alternative diagnostic modalities after negative capsule endoscopy[J]. Gastrointest Endosc, 2008, 68 (8): 1209-1214.

42 Hakim FA, Alexander JA, Huprich JE, et al. CT-enterography may identify small bowel tumors not detected by capsule endoscopy: eight years experience at Mayo Clinic Rochester[J]. Dig Dis Sci, 2011, 56 (10): 2914-2919.

43 Mata A, Llach J, Castells A, et al. A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes[J]. Gastrointest Endosc, 2005, 61 (6): 721-725.

44 Caspari R, von Falkenhausen M, Krautmacher C, et al. Comparison of capsule endoscopy and magnetic resonance imaging for the detection of polyps of the small intestine in patients with familial adenomatous polyposis or with Peutz-Jeghers’ syndrome[J]. Endoscopy, 2004, 36 (12): 1054-1059.

45 Postgate A, Hyer W, Phillips R, et al. Feasibility of video capsule endoscopy in the management of children with Peutz-Jeghers syndrome: a blinded comparison with barium enterography for the detection of small bowel polyps[J]. J Pediatr Gastroenterol Nutr, 2009, 49 (4): 417-423.

46 Gupta A, Postgate AJ, Burling D, et al. A prospective study of MR enterography versus capsule endoscopy for the surveillance of adult patients with Peutz-Jeghers syndrome[J]. AJR Am J Roentgenol, 2010, 195 (1): 108-116.

47 Akin E, Demirezer Bolat A, Buyukasik S, et al. Com-parison between capsule endoscopy and magnetic resonance enterography for the detection of polyps of the small intestine in patients with familial adenomatous polyposis[J]. Gastroenterol Res Pract, 2012, 2012: 215028.

48 Matsumoto T, Esaki M, Moriyama T, et al. Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis[J]. Endoscopy, 2005, 37 (9): 827-832.

49 Rokkas T, Niv Y. The role of video capsule endoscopy in the diagnosis of celiac disease: a meta-analysis[J]. Eur J Gastroenterol Hepatol, 2012, 24 (3): 303-308.

50 Tachecí I, Bradna P, Douda T, et al. NSAID-induced enteropathy in rheumatoid arthritis patients with chronic occult gastrointestinal bleeding: a prospective capsule endoscopy study[J]. Gastroenterol Res Pract, 2013, 2013: 268382.

51 Domingos TA, Moura EG, Mendes DC, et al. Comparative evaluation of esophageal Barrett’s epithelium through esophageal capsule endoscopy and methylene blue chromoendoscop[J]. Rev Gastroenterol Mex, 2013, 78 (2): 57-63.

52 Ishiguro H, Saito S, Imazu H, et al. Esophageal capsule endoscopy for screening esophageal varices among Japanese patients with liver cirrhosis[J]. Gastroenterol Res Pract, 2012, 2012: 946169.

53 Chavalitdhamrong D, Jensen DM, Singh B, et al. Capsule endoscopy is not as accurate as esophago-gastroduodenoscopy in screening cirrhotic patients for varices[J]. Clin Gastroenterol Hepatol, 2012, 10 (3): 254-258.

54 Wigg AJ, Bull J, de Silva M, et al. Influence of operator experience and reporting time on the accuracy of esophageal capsule endoscopy screening for varices[J]. Gastroenterol Nurs, 2011, 34 (4): 303-311.

55 Daniel A, Praveen G. Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices[J]. World J Gastroenterol, 2010, 16 (6): 785-786.

56 Laurain A, de Leusse A, Gincul R, et al. Oesophageal capsule endoscopy versus oesophago-gastroduodenoscopy for the diagnosis of recurrent varices: A prospective multicentre study[J]. Dig Liver Dis, 2014, 46 (6): 535-540.

57 Shah A, Boettcher E, Fahmy M, et al. Screening pre-bariatric surgery patients for esophageal disease with esophageal capsule endoscopy[J]. World J Gastroenterol, 2013, 19 (37): 6188-6192.

58 Eisen GM, Eliakim R, Zaman A, et al. The accuracy of PillCam ESO capsule endoscopy versus conventional upper endoscopy for the diagnosis of esophageal varices: a prospective three-center pilot study[J]. Endoscopy, 2006, 38 (1): 31-35.

59 Lapalus MG, Ben Soussan E, Gaudric M, et al. Esophageal capsule endoscopyvs. EGD for the evaluation of portal hypertension: a French prospective multicenter comparative study[J]. Am J Gastroenterol, 2009, 104 (5): 1112-1118.

60 Di Biase L, Dodig M, Saliba W, et al. Capsule endoscopy in examination of esophagus for lesions after radio-frequency catheter ablation: a potentialtool to select patients with increased risk of complications[J]. J Cardiovasc Electrophysiol, 2010, 21 (8): 839-844.

61 Heresbach D, Leray E, d’Halluin PN, et al. Diagnostic accuracy of esophageal capsule endoscopy versus conventional upper digestive endoscopy forsuspected esophageal squamous cell carcinoma[J]. Endoscopy, 2010, 42 (2): 93-97.

62 Gerson LB. Screening for esophageal varices: is esophageal capsule endoscopy ready for prime time?[J]. J Clin Gastroenterol, 2009, 43 (10): 899-901.

63 Waterman M, Gralnek IM. Capsule endoscopy of the esophagus[J]. J Clin Gastroenterol, 2009, 43 (7): 605-612.

64 Bhardwaj A, Hollenbeak CS, Pooran N, et al. A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett’s esophagus in patients with gastroesophageal reflux disease[J]. Am J Gastroenterol, 2009, 104 (6): 1533-1539.

65 Liao Z, Gao R, Xu C, et al. Sleeve string capsule endoscopy for real-time viewing of the esophagus: a pilot study (with video) [J]. Gastrointest Endosc, 2009, 70 (2): 201-209.

66 Nakos G, Karagiannis S, Ballas S, et al. A study comparing tolerability, satisfaction and acceptance of three different techniques for esophageal endoscopy: sedated conventional, unsedated peroral ultra thin, and esophageal capsule[J]. Dis Esophagus, 2009, 22 (5): 447-452.

67 Frenette CT, Kuldau JG, Hillebrand DJ, et al. Com-parison of esophageal capsule endoscopy and esophagogastroduodenoscopy fordiagnosis of esophageal varices[J]. World J Gastroenterol, 2008, 14 (28): 4480-4485.

68 de Franchis R, Eisen GM, Laine L, et al. Esophageal capsule endoscopy for screening and surveillance of esophageal varices inpatients with portal hypertension[J]. Hepatology, 2008, 47 (5): 1595-1603.

69 Gralnek IM, Adler SN, Yassin K, et al. Detecting esophageal disease with second-generation capsule endoscopy: initial evaluation of the PillCam ESO2[J]. Endoscopy, 2008, 40 (4): 275-279.

70 Galmiche JP, Sacher-Huvelin S, Coron E, et al. Screening for esophagitis and Barrett’s esophagus with wireless esophageal capsule endoscopy: a multicenter prospective trial in patients with reflux symptoms[J]. Am J Gastroenterol, 2008, 103 (3): 538-545.

71 Delvaux M, Papanikolaou IS, Fassler I, et al. Esophageal capsule endoscopy in patients with suspected esophageal disease: double blinded comparison with esophago-gastroduodenoscopy and assessment of interobserver variability[J]. Endoscopy, 2008, 40 (1): 16-22.

72 Qureshi WA, Wu J, Demarco D, et al. Capsule endoscopy for screening for short-segment Barrett’s esophagus[J]. Am J Gastroenterol, 2008, 103 (3): 533-537.

73 Sharma P, Wani S, Rastogi A, et al. The diagnostic accuracy of esophageal capsule endoscopy in patients with gastroesophageal reflux disease and Barrett’s esophagus: a blinded, prospective study[J]. Am J Gastroenterol, 2008, 103 (3): 525-532.

74 Gerson L, Lin OS. Cost-benefit analysis of capsule endoscopy compared with standard upper endoscopy for the detection of Barrett’s esophagus[J]. Clin Gastroenterol Hepatol, 2007, 5 (3): 319-325.

75 Rubenstein JH, Inadomi JM, Brill JV, et al. Cost utility of screening for Barrett’s esophagus with esophageal capsule endoscopy versus conventional upper endoscopy[J]. Clin Gastroenterol Hepatol, 2007, 5 (3): 312-318.

76 Lin OS, Schembre DB, Mergener K, et al. Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux[J]. Gastrointest Endosc, 2007, 65 (4): 577-583.

77 Gralnek IM, Rabinovitz R, Afik D, et al. A simplified ingestion procedure for esophageal capsule endoscopy: initial evaluation in healthy volunteers[J]. Endoscopy, 2006, 38 (9): 913-918.

78 Sánchez-Yagüe A, Caunedo-Alvarez A, García-Montes JM, et al. Esophageal capsule endoscopy in patients refusing conventional endoscopy for the study of suspected esophageal pathology[J]. Eur J Gastroenterol Hepatol, 2006, 18 (9): 977-983.

79 Lapalus MG, Dumortier J, Fumex F, et al. Esophageal capsule endoscopy versus esophago-gastroduodenoscopy for evaluating portal hypertension: aprospective comparative study of performance and tolerance[J]. Endoscopy, 2006, 38 (1): 36-41.

80 Eliakim R, Sharma VK, Yassin K, et al. A prospective study of the diagnostic accuracy of PillCam ESO esophageal capsule endoscopy versus conventional upper endoscopy in patients with chronic gastroesophageal reflux diseases[J]. J Clin Gastroenterol, 2005, 39 (7): 572-578.

81 Chandran S, Testro A, Urquhart P, et al. Risk stratification of upper GI bleeding with an esophageal capsule[J]. Gastrointest Endosc, 2013, 77 (6): 891-898.

82 Fernandez-Urien I, Borobio E, Elizalde I, et al. Z-line examination by the PillCam SB: prospective comparison of three ingestion protocols[J]. World J Gastroenterol, 2010, 16 (1): 63-68.

83 White CM, Kilgore ML. PillCam ESO versus esophago-gastroduodenoscopy in esophageal variceal screening: A decision analysis[J]. J Clin Gastroenterol, 2009, 43 (10): 975-981.

84 Ruff KC, Sharma VK. Is capsule endoscopy effective for screening and surveillance of esophageal varices in patients with portal hypertension?[J]. Nat Clin Pract Gastroenterol Hepatol, 2009, 6 (1): 10-11.

85 Goulas S, Triantafyllidou K, Karagiannis S, et al. Capsule endoscopy in the investigation of patients with portal hypertension and anemia[J]. Can J Gastroenterol, 2008, 22 (5): 469-474.

86 De Jonge PJ, Van Eijck BC, Geldof H, et al. Capsule endoscopy for the detection of oesophageal mucosal disorders: a comparison of two different ingestion protocols[J]. Scand J Gastroenterol, 2008, 43 (7): 870-877.

87 Hagel AF, G?bele E, Raithel M, et al. Colon capsule endoscopy: Detection of colonic polyps compared with conventional colonoscopy and visualization of extracolonic pathologies[J]. Can J Gastroenterol Hepatol, 2014, 28 (2): 77-82.

88 Ramos L, Alarcón O, Adrian Z, et al. One-day versus two-day cleansing for colon capsule endoscopy: a prospective randomized pilot study[J]. Gastroenterol Hepatol, 2014, 37 (3): 101-106.

89 Farnbacher MJ, Krause HH, Hagel AF, et al. Quick View video preview software of colon capsule endoscopy: reliability in presenting colorectal polyps as compared to normal mode reading[J]. Scand J Gastroenterol, 2014, 49 (3): 339-346.

90 Triantafyllou K, Viazis N, Tsibouris P, et al. Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice[J]. Gastrointest Endosc, 2014, 79 (2): 307-316.

91 Adler SN, Hassan C, Metzger Y, et al. Second-generation colon capsule endoscopy is feasible in the out-of-clinic setting[J]. Surg Endosc, 2014, 28 (2): 570-575.

92 Hosoe N, Matsuoka K, Naganuma M, et al. Applicability of second-generation colon capsule endoscope to ulcerative colitis: a clinical feasibility study[J]. J Gastroenterol Hepatol, 2013, 28 (7): 1174-1179.

93 Meister T, Heinzow HS, Domagk D, et al. Colon capsule endoscopy versus standard colonoscopy in assessing disease activity of ulcerative colitis: a prospective trial[J]. Tech Coloproctol, 2013, 17 (6): 641-646.

94 Alarcón-Fernández O, Ramos L, Adrián-de-Ganzo Z, et al. Effects of colon capsule endoscopy on medical decision making in patients with incomplete colonoscopies[J]. Clin Gastroenterol Hepatol, 2013, 11 (5): 534-540.

95 Adler S, Hassan C, Metzger Y, et al. Accuracy of automatic detection of small-bowel mucosa by second-generation colon capsule endoscopy[J]. Gastrointest Endosc, 2012, 76 (6): 1170-1174.

96 Kakugawa Y, Saito Y, Saito S, et al. New reduced volume preparation regimen in colon capsule endoscopy[J]. World J Gastroenterol, 2012, 18 (17): 2092-2098.

97 Mussetto A, Triossi O, Gasperoni S, et al. Colon capsule endoscopy may represent an effective tool for colorectal cancer screening: a single-centre series[J]. Dig Liver Dis, 2012, 44 (4): 357-358.

98 Fernández-Urién I, Ostiz M, Jiménez J. Avoiding incomplete conventional colonoscopies: PillCam? COLON capsule endoscopy[J]. Rev Esp Enferm Dig, 2011, 103 (7): 389-391.

99 Spada C, Hassan C, Munoz-Navas M, et al. Second-generation colon capsule endoscopy compared with colonoscopy[J]. Gastrointest Endosc, 2011, 74 (3): 581-589.

100 Spada C, Hassan C, Ingrosso M, et al. A new regimen of bowel preparation for PillCam colon capsule endoscopy: a pilot study[J]. Dig Liver Dis, 2011, 43 (4): 300-304.

101 Spada C, Hassan C, Sturniolo GC, et al. Literature review and recommendations for clinical application of colon capsule endoscopy[J]. Dig Liver Dis, 2011, 43 (4): 251-258.

102 Sacher-Huvelin S, Coron E, Gaudric M, et al. Colon capsule endoscopyvs. colonoscopy in patients at average or increased risk of colorectal cancer[J]. Aliment Pharmacol Ther, 2010, 32 (9): 1145-1153.

103 Pilz JB, Portmann S, Peter S, et al. Colon capsule endoscopy compared to conventional colonoscopy under routine screening conditions[J]. BMC Gastroenterol, 2010, 10: 66.

104 Rokkas T, Papaxoinis K, Triantafyllou K, et al. A meta-analysis evaluating the accuracy of colon capsule endoscopy in detecting colon polyps[J]. Gastrointest Endosc, 2010, 71 (4): 792-798.

105 Spada C, Hassan C, Marmo R, et al. Meta-analysis shows colon capsule endoscopy is effective in detecting colorectal polyps[J]. Clin Gastroenterol Hepatol, 2010, 8 (6): 516-522.

106 Schoofs N, Devière J, Van Gossum A. PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study[J]. Endoscopy, 2006, 38 (10): 971-977.

107 Ye CA, Gao YJ, Ge ZZ, et al. PillCam colon capsule endoscopy versus conventional colonoscopy for the detection of severity and extent of ulcerative colitis[J]. J Dig Dis, 2013, 14 (3): 117-124.

108 Hartmann D, Keuchel M, Philipper M, et al. A pilot study evaluating a new low-volume colon cleansing procedure for capsule colonoscopy[J]. Endoscopy, 2012, 44 (5): 482-486.

109 Spada C, Hassan C, Riccioni ME, et al. False positive at colon capsule endoscopy or false negative at conventional colonoscopy?[J]. Endoscopy, 2010, 42 (5): 427-428.

110 Eliakim R, Yassin K, Niv Y, et al. Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy[J]. Endoscopy, 2009, 41 (12): 1026-1031.

111 Triantafyllou K, Tsibouris P, Kalantzis C, et al. PillCam colon capsule endoscopy does not always complement incomplete colonoscopy[J]. Gastrointest Endosc, 2009, 69 (3 Pt 1): 572-576.

112 Eliakim R, Fireman Z, Gralnek IM, et al. Evaluation of the PillCam colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study[J]. Endoscopy, 2006, 38 (10): 963-970.

113 Stanich PP, Kleinman B, Betkerur K, et al. Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices[J]. Dig Endosc, 2014 [Epub ahead of print].

114 Banerjee R, Bhargav P, Reddy P, et al. Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical trial[J]. J Gastroenterol Hepatol, 2007, 22 (12): 2060-2063.

115 Boivin ML, Lochs H, Voderholzer WA. Does passage of a patency capsule indicate small-bowel patency? A prospective clinical trial?[J]. Endoscopy, 2005, 37 (9): 808-815.

116 Cohen SA, Gralnek IM, Ephrath H, et al. The use of a patency capsule in pediatric Crohn’s disease: a prospective evaluation[J]. Dig Dis Sci, 2011, 56 (3): 860-865.

117 Signorelli C, Rondonotti E, Villa F, et al. Use of the Given patency system for the screening of patients at high risk for capsule retention[J]. Dig Dis Sci, 2011, 56 (3): 860-865.

118 Postgate AJ, Burling D, Gupta A, et al. Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: a 3-year technical review[J]. Dig Dis Sci, 2008, 53 (10): 2732-2738.

119 Herrerias JM, Leighton JA, Costamagna G, et al. Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy[J]. Gastrointest Endosc, 2008, 67 (6): 902-909.

120 Makipour K, Modiri AN, Ehrlich A, et al. Double balloon enteroscopy: Effective and minimally invasive method for removal of retained video capsules[J]. Dig Endosc, 2014[Epub ahead of print].

121 Chung JW, Hwang HJ, Chung MJ, et al. Safety of capsule endoscopy using human body communication in patients with cardiac devices[J]. Dig Dis Sci, 2012, 57 (6): 1719-1723.

122 Bandorski D, Jakobs R, Brück M, et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: (re)evaluation of the Current State in Germany, Austria, and Switzerland 2010[J]. Gastroenterol Res Pract, 2012, 2012: 717408.

123 Bandorski D, Lotterer E, Hartmann D, et al. Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter-defibrillators - a retrospective multicenter investigation[J]. J Gastrointestin Liver Dis, 2011, 20 (1): 33-37.

124 Bandorski D, Irnich W, Brück M, et al. Capsule endoscopy and cardiac pacemakers: investigation for possible interference[J]. Endoscopy, 2008, 40 (1): 36-39.

125 Bandorski D, H?ltgen R, Stunder D, et al. Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices[J]. Ann Gastroenterol, 2014, 27 (1): 3-8.

126 Cuschieri JR, Osman MN, Wong RC, et al. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review[J]. World J Gastrointest Endosc, 2012, 4 (3): 87-93.

127 Gao YJ, Ge ZZ, Chen HY, et al. Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield[J]. Gastrointest Endosc, 2010, 72 (1): 103-108.