468 cases esophagogastroduodenoscopy performed by family physicians

Joo, Seong Won; Cho, Jung Jin; Yun, Young Ho; Kang, Hun Il

Abstract

BACKGROUND: Although family physicians are performing an increasing number of esophagogastroduodenoscopie(EGDs), there is little research conducted in Korea. Thus, the purpose of this research is to assess the ability of family physicians in performing EGD.
METHODS
All EGDs performed by family physicians in the department of family medicine of one general hospital from January 1995 to December 1996 were reviewed retrospectively through medical records. Ten including physicians a family physician and nine family residents, performed EGDs five tirnes per week.
RESULTS
4,468 EGDs were performed on 4,313 persons during the two years. No major complications were noted and all of the procedures were completely investigated to the second portion of the duodenum Normal findings were 1,268 cases(28.4%) and abnormal findings were 3,200 cases(71.6%). Among the abnormal findings, gastritis was the most common finding(73.7%). The most common pathologic diagnosis was peptic ulcer 37.7%(177/470cases). Positive rate of CLO test was 89.4%. Family physicians, endoscopic diagnosis agreed with pathologic reports in 86.6%. The number of EGDs performed by each family physicians ranged from 2 to 1,503 cases. Data of six physicians who performed more than 200 EGDs for their diagnostic were comparatively analyzed ability. Diagnosis of normal, gastritis or gastric ulcer was significantly different(p<0.05) according to each physicians but the diagnosis of duodenal ulcer was not statistically different(p>0.05). There was little difference among physicians in the biopsy rate. The agreement ratio between endoscopic diagnoses and pathologic reports among those physicians who performed more than 200 procedures were 79.7- 93.3% and were not statistically different(p>0.05).
CONCLUSIONS
This study is the first report of EGDs performed by family physician in Korea. Some family physicians performed more than 4,000 EGDs without major cornplications in primary care. These data confirm the ability of some family physicians to perform EGD. Biopsy analysis indicates the diagnostic accuracy is high. Further study on performance of EGD by family physicians and its standardization concerning description of endoscopic findings are needed.