Hi everyone I'm dr. Maura Gerson senior associate editor for gastrointestinal endoscopy it's my pleasure to have with me dr. Mona reservoir the second year gasps knology fellow at California Pacific Medical Center in San Francisco we're here today discuss our paper published in the upcoming issue of gie entitled retention associated with video capsule endoscopy systematic review and meta-analysis as most of you know video capsule endoscopy isn't available in the United States since 2000 and its main indications for evaluation of patients and suspected small mouths bleeding inflammatory bowel disease and other suspected small amount disorders measures approximately 11 x 26 millimeters and the main feared complication is potential retention which is incited to occur in approximately one to two percent of patients is bleeding but anywhere from thirteen percent even up to twenty-five percent of patients with Crohn's disease particularly in the pediatric population so the main indications about the study was to decidedly analyze retention rates associated with capsule endoscopy when administered for different indications gun or method but thank you for our method section we did a comprehensive literature with you in pubmed and scopus we were the controversial review was not grown I'm 1995 to 2015 we were looking at studies that were on cat video so endoscopy and reported the retention rates we were specifically looking at studies that reported retention rates for smallville bleeding over and occult inflammatory bowel disease divided into suspected and established and abdominal pain and diarrhea we further did a sub analysis looking at those studies that had done a patency capsule or a CT or MRI enter ography to look at to look at structures and patients prada and impatient who had strictures on pnc castle and excluding those patients and then further doing a pretty capsule endoscopy and reporting the retention rates for the videocast endoscopy from a statistical point of view we perform a standard of analysis using program called comprehensive meta-analysis and calculated pools retention rates for each of the various categories we then constructed forests also shown in the paper and a publication ended analysis of potential publication bias there were more than ten studies in each category for the patients with suspected small valve leading the overall retention rate was approximately two percent and the most common cause of strictures in more than fifteen percent of the patients most the time do neither and said or Crohn's disease and close to forty seven percent of patients and required about sixty percent of the cohort to undergo surgical rossetti intersection we don't know exactly in how many cases in terrassa be attempted and this technology was only available in the US after 2004 for exact shows all disease we for suspected patients these divisions who had symptoms consistent with inflammatory bowel disease the retention rate was three-point-six percent and again most of these will do the scriptures about seventy percent of them and if a patient with established IBD the retention rates was about 8.

2 percent and again about eighty-seven percent of these were due to strangers for patients who underwent very helpful and not computer abdominal pain and diarrhea the retention rates were about 2.2% about twenty-four percent of these were due descriptors looking at all indications in all the studies that we analyzed the retention rate again was about two percent and when on our self-analysis looking at seven studies that performed either a patency capsule or a CT angiography there were about the retention rates initially was a pain see castle was about twelve percent and then once those patients with retention were excluded the video capsule retention rate was 2.7% so considerably decreased about fifty four percent of all of the retention rates for Duda strictures a minority of these patients about only about eleven percent developed.

Obstructive symptoms however would that number greater than fifty percent did undergo surgery to remove the castle I'll community so in summary we show that patients according to the guidelines with suspected inflammatory bowel disease or established IVD continue to have relatively high retention rates approximately five percent and establish patients and that performing either at patency capsule or an mr angiography initially had a retention rate around twelve percent but this is reduced to two-point-seven percent after these studies were performed so it's therefore worth while studying these patients prior to administration of council just to avoid the complication of retention these patients obviously can be managed now with the event across Asia remove the council is retained and again this paper I think is valuable because it helps establish for patients that are going capsule with the potential for retention is in various indications thank you thank you.