TBA (22W162)

Time Rich And Photo Poor

Author(s)

J. Peacock C. Lahiff E. Keating

Department(s)/Institutions

Gastroenterology Department, Mater Hospital, Dublin

Introduction

Gastroscopies are an important diagnostic tool however procedure quality can vary between practitioners. Guidelines on ensuring 10 anatomical photographs to achieve high quality gastroscopy were published by ESGE in 2016.

Aims/Background

To assess a cross-section of gastroscopies performed in the Mater Hospital and determine performance against ESGE guidelines.

Method

A retrospective analysis was conducted of gastroscopies completed in a one week period. Procedural time was recorded by first and last image timestamps captured on our endoscopy reporting system (ERS) . Two endoscopists assessed ten anatomical landmarks and scored on a 0 to 3 scale depending on photo quality, giving a maximal score of 30.

Results

Seventy-four gastroscopies were analysed over the study period. Median procedural time was 04:00 minutes according to endoscopic time stamps (Range 1-12 minutes). Mean sedation was 2.3mg midazolam and 28.4mcg fentanyl with 15% completed unsedated. Clear images of D2 and fundus were observed in 84% and 72% respectively. Most commonly omitted photographs were the greater curve in retroflexion (74%), incisura (73%) and proximal oesophagus (65%). No OGDs achieved a 30/30 score (10 photos scoring 3/3). The range was 6 – 29, with an average score of 17. There was no correlation between procedural time and photo scores (R = -0.02926, CI -0.256 to 0.201).

Conclusions

Inspection technique in this series falls short of ESGE Guidelines. Procedure duration does not appear to impact upon number or quality of images captured. Whether these shortfalls impact upon lesion detection for gastroscopy needs to be considered. A repeat audit is planned post endoscopic staff education.