Retrospective dual-center study of the benefit of diagnostic gastroscopy with forward-optic before endoscopy with side-viewing optic ; Retrospektive Dual-Center Studie zum Zusatznutzen einer diagnostischen Gastroskopie mit prograder Optik vor der Endoskopie mit Seitenblickoptik

Background: Duodenoscopes and echoendoscopes lack flexibility, have narrower field of view, and lack modern optical techniques compared with standard gastroscopes. It is unknown whether gastroscopy should be performed routinely before endoscopy with non-forward optic to avoid missing lesions, create a roadmap and probably reduce the complications associated with endoscopic retrograde cholangiopancreatography / endoscopic ultrasonography (ERCP/EUS). Since no consensus has been reached, the practice is widely variable and depends on the endoscopist’s experience and preference. Aim: This study aimed to determine the proportion of patients with intraluminal relevant lesions when gastroscopy is performed routinely before ERCP or EUS, to determine whether patient’s age, hemoglobin level, and intake of anticoagulants are associated with the presence of relevant lesions, and to evaluate the impact of EGD findings on the subsequent ERCP/EUS. Methods: This is a dual-center retrospective study conducted at the Charité- University Medicine and Vivantes Hospital Spandau, which is an academic center affiliated with Charité, between August 2020 and December 2020. Patients underwent ERCP or EUS for non-luminal diagnosis were included in this study. Results: A total of 245 patients (145 at Charité- University Medicine and 100 at Vivantes Hospital Spandau) were included in this study. Among them, 95 patients had relevant lesions detected by esophagogastroduodenoscopy (EGD) (38.78%, 95% confidence interval: 32.89–45.01). Patients with relevant lesions were significantly older and had lower hemoglobin levels than those without lesions (p = 0.029 and < 0.001, respectively). No association was observed between the detection of relevant lesions and the intake of anticoagulants (p = 0.336). The EGD findings had a direct impact on the subsequent ERCP/EUS in 17 patients (6.93%). Out of 15 patients with stenosis, dilatation was needed in 6 patients (2.4%) to facilitate the passage of duodenoscopes or echoendoscope. Conclusion: We ...