Orientation in upper gastrointestinal endoscopy—the only way is up
File(s)WJGE-15-146.pdf (4.15 MB)
Published version
Author(s)
Sivananthan, A
Kerry, G
Darzi, A
Patel, K
Patel, N
Type
Journal Article
Abstract
BACKGROUND Oesophagogastroduodenoscopy is the gold standard investigation for the upper gastrointestinal (UGI) tract. Orientation during endoscopy is challenging and United Kingdom training focusses on technical competence and procedural safety. The reported location of UGI pathologies is crucial to post-endoscopic planning. AIM To evaluate endoscopists’ ability to spatially orientate themselves within the UGI tract. METHODS A cross sectional descriptive study elicited, using an anonymised survey, the ability of endoscopists to orientate themselves within the UGI tract. The primary outcome was percentage of correct answers from all surveyed; secondary outcomes were percentage of correct answers from experienced vs novice endoscopists. Pearson’s χ2 test was applied to compare groups. RESULTS Of 188 respondents, 86 were experienced endoscopists having completed over 1000 endoscopies. 44.4% of respondents correctly identified the anterior stomach and 47.3% correctly identified the posterior of the second part of the duodenum (D2). Experienced endoscopists were significantly more likely than novice to identify the anterior stomach correctly [61.6% vs 31.3%, X2 (1, n = 188) = 11.10, P = 0.001]. There was no significant difference between the two groups in identifying the posterior of D2. CONCLUSION The majority of endoscopists surveyed were unable to identify key landmarks within the UGI tract. Endoscopic orientation appears to improve with experience yet there are some areas still not well recognised. This has potential considerable impact on post-endoscopic management of patients with posterior duodenal ulcers being more likely to perforate and associated with a higher rebleeding risk. We suggest the development of a consensus statement on endoscopic description.
Date Issued
2023-03-16
Online Publication Date
2023-03-27T14:20:37Z
Date Acceptance
2023-02-21
ISSN
1948-5190
Publisher
Baishideng Publishing Group Co. Limited
Start Page
146
End Page
152
Journal / Book Title
World Journal of Gastrointestinal Endoscopy
Volume
15
Issue
3
Copyright Statement
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Identifier
https://www.wjgnet.com/1948-5190/full/v15/i3/146.htm
Publication Status
Published
Date Publish Online
2023-03-16