AB160. SOH21AS139. Outside our scope: an audit of compliance with the BSG/AUGIS standards in photo-documentation in upper GI endoscopy

Background: Oesophago-gastric-duodenoscopy (OGD) is the diagnostic gold standard investigation for pathologies of the upper gastrointestinal tract. However, lesions may be missed due to inadequate technique and failure to visualise all mucosal surfaces. At present, there is no agreed global photo-documentation protocol. The British Society of Gastroenterology (BSG) and Association of Upper GI surgeons of Great Britain and Ireland (AUGIS) guidelines, published in Sept 2017, recommend photo-documentation of eight anatomical landmarks during OGD: upper oesophagus, lower oesophagus, fundus, gastric body, incisura, antrum, duodenal bulb, distal duodenum.

Methods: Retrospective review of electronic OGD reports. Inclusion criteria: all elective OGDs with electronic reports performed between April 4th and June 28th 2019. Exclusion criteria: emergency, therapeutic OGDs. Recorded data: patient demographics, endoscopist specialty, indication, number of photos, anatomical sites photographed, pathology, pathology identified and whether photographed.

Results: Twenty-two OGDs (11%) were fully compliant with the guidelines. The esophagogastric junction, second part of the duodenum and the fundus were the most commonly photographed (95%, 90% and 88.5% respectively). The incisura was the most commonly missed being photographed only 26.5% of the time. Twenty-six percent of OGDs had only photographic evidence of four of the eight landmarks. Where the indication for OGD was dysphagia only 33% of OGDs had photo documentation of the upper Oesophagus.

Conclusions: We found an overall poor compliance with the BSG/AUGIS guidelines. We have completed an education session on the importance of high quality OGDs in the diagnosis of upper gastrointestinal (UGI) malignancy and are gathering data to complete the audit loop at present.

Keywords: Audit; cancer; endoscopy; oesophagus; stomach