Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.539
Peer-review started: October 15, 2023
First decision: December 6, 2023
Revised: December 20, 2023
Accepted: January 9, 2024
Article in press: January 9, 2024
Published online: February 27, 2024
Processing time: 133 Days and 2.1 Hours
Accurate estimation of esophageal varices (EVs) is essential because variceal diameter is used to determine the exact diagnostic category, appropriate therapy, and observational intervals for patients with liver cirrhosis. However, visual estimation of EV size by endoscopists are often inaccurate.
Upper gastrointestinal bleeding due to EVs is associated with high morbidity and mortality rates. As the risk of variceal bleeding is assessed by variceal size, accurate measurement of EV size is important. We therefore need to improve the accuracy of endoscopists to estimate EV size.
We aimed to evaluate whether open biopsy forceps (BF) can be used to improve the accuracy of binary classification of EV size.
A simulated EV model with known EV sizes was constructed. An online image-based test comprising 11 endoscopic images of simulated EV without BF and 11 endoscopic images of EV with BF was evaluated in random order by 52 endoscopists.
The ability of endoscopists to correctly classify the varices according to size (small, ≤ 5 mm vs large, > 5 mm) was improved from 71.85% to 82.17% with the use of open BF (P < 0.001).
This study showed that using open BF as a reference may improve the assessment of variceal size. However, its use in clinical endoscopy practice requires further investigation.
Using open BF as a reference may significantly improve the accuracy of esophageal variceal size binary classification. Additional clinical studies using BF during gastroscopy are required to confirm our findings.