Capsule endoscopy with PILLCAM ESO for detecting esophageal varices: A meta-analysis

Aim. The aim of the present study was to perform meta-analysis of studies that compare diagnostic capabilities of esophageal capsule endoscopy (ECE) against conventional esophago-gastro-duodenoscopy (EGD) in detecting esophageal varices. Methods. A literature search is done for studies that compared the performance of ECE and EGD in screening and surveillance of esophageal varices. Data was extracted to estimate the pooled sensitivity, pooled specificity, positive diagnostic ratio, negative diagnostic ratio and diagnostic odds ratio. Results. We included 9 studies and total number of patients was 631. There were 12 capsule failures so data was available for 619 patients. The pooled sensitivity and specificity of CE for detecting esophageal varices were 83% and 85% respectively. The pooled positive likelihood and negative likelihood ratios are 4.09 and 0.25, respectively. Pooled diagnostic odds ratio was 24.92. Conclusion. In our meta-analysis PillCam ESO performed well in detecting esophageal varices but it was not comparable to EGD; it can be an acceptable alternative in certain situations but cannot be recommended to replace EGD.