TBA (22W101)

An Audit Of The Photo-Documentation Of Key Anatomical Landmarks During Upper Gastrointestinal Endoscopy Procedures Performed At Mayo University Hospital

Author(s)

K. Khan, R. Nagpal, I. Abdalatif, B. Egan, G. Harkin, D. Tighe

Department(s)/Institutions

Department of Gastroenterology, Mayo General Hospital (MGH), Castlebar, Co. Mayo, Ireland

Introduction

Photo-documentation is the cornerstone of quality assurance in endoscopy, maximizing mucosal inspection and pathology recognition. The British Society of Gastroenterology (BSG)-Association of Upper Gastrointestinal Surgeons of Great Britain & Ireland (AUGIS) position statement strongly recommended that along with any detected pathology, the endoscopist should photo-document eight anatomical landmarks.

Aims/Background

To evaluate the photo-documentation standard in UGI endoscopy in an Irish model 3 hospital compared to other centres.

Method

We undertook a retrospective, single-centre audit of photo-documentation in oesophagogastroduodenoscopies (OGDs) performed between January-April 2022. EndoVault OGD reports were randomly selected and reviewed. Exclusion criteria were colonoscopies and procedures performed by surgeons. All photographs taken during an OGD were analysed for representative images of nine landmarks, including the papilla.

Results

183 OGDs were analysed. Common indications included dyspepsia, reflux-type symptoms, abdominal pain and anaemia. Percentage photo-documentation of landmarks were; upper oesophagus – 48.09%, gastro-oesophageal junction – 86.34%, fundus in retroflexion – 96.17%, body of stomach – 65.57%, incisura in retroflexion – 60.66%, gastric antrum – 86.34%, duodenal bulb – 69.40%, distal duodenum – 91.26% and papilla – 47.54%. Endoscopists performing only 50 of 183 OGDs (27.32%) studied were concordant with the quality standard. 20.22% also included the papilla. Stations most commonly missed were the upper oesophagus and papilla. The best photo documented landmarks were the fundus in retroflexion and the distal duodenum.

Conclusions

Currently, the MGH endoscopic unit is not meeting the BSG-AUGIS quality standard. However, compared to data published by other centres, our department outperforms in the photo-documentation of all landmarks. We aim to re-audit once cost-effective interventions like workshops and infographics have been implemented.