{
  "abstract": "Introduction Current BSG guidelines recommend repeat oesophagogastroduodenoscopy (OGD) at 6–8 weeks to confirm healing and exclude malignancy in patients with gastric ulcers. However, routine follow-up endoscopy may be unnecessary in low-risk patients. The Endoscopic Gastric Ulcer Score (EGUS), as proposed in NHS Lothian guidance, has been developed as a risk-stratification tool to identify patients at low risk of malignancy.The main aim is to evaluate gastric ulcer outcomes in our cohort in accordance with NHS Lothian EGUS recommendations and to assess whether repeat OGD can be safely avoided in patients with EGUS <3 and benign histology at index endoscopy.Methods This retrospective single-centre study was conducted at Norfolk and Norwich University Hospital. Patients diagnosed with gastric ulcers on index OGD between October 2024 and June 2025 were included. EGUS was calculated at initial endoscopy in line with NHS Lothian recommendations. Histological outcomes, diagnosis of gastric malignancy, and findings on repeat OGD were analysed.Results A total of 221 patients with gastric ulcers were identified. Eight patients (3.6%) were diagnosed with gastric cancer at index OGD. Of the remaining cohort, 167 patients underwent repeat OGD, all of whom demonstrated complete ulcer healing. No malignancies were detected on follow-up endoscopy in patients with EGUS <3 and benign histology at index OGD.Conclusions In this single-centre experience, patients with an EGUS score <3 and benign histology at index OGD, as defined by NHS Lothian criteria, had no adverse outcomes on follow-up. It was found that the patients who had repeat OGDs with benign biopsies had healed ulcers. Retrospectively re-analysing these patients, they had EGUS <3. This suggests that repeat OGD may be safely avoided in these low-risk groups of patients, hence reducing unnecessary procedures, endoscopic and financial burden - given its high negative predictive value (96.3%). This also helps keeping in with principles of green endoscopy as numerous unnecessary repeat OGDs can be avoided. In addition to this, avoiding repeat OGDs given the adherence of protocol can have a significant financial benefit. During our study of 8 months, a total of £47,000 could have been saved (assuming each OGD costs £500). However, prospective multicentre studies are warranted to validate these findings in the future.",
  "authors": [
    {
      "affiliations": [
        "Norfolk And Norwich University Hospital, Norwich, United Kingdom"
      ],
      "name": "Drishya Dhungana"
    },
    {
      "affiliations": [
        "Norfolk And Norwich University Hospital, Norwich, United Kingdom"
      ],
      "name": "Majid Iqbal"
    },
    {
      "affiliations": [
        "Norfolk And Norwich University Hospital, Norwich, United Kingdom"
      ],
      "name": "Richard Tighe"
    }
  ],
  "title": "P313 The edinburgh gastric ulcer score (EGUS):evaluation of risk tool for gastric ulcer follow-up: single centre experience at Norfolk& Norwich university hospital",
  "uid": "4d6760f1-c973-5a1f-b7e2-3fcdfb0f339e"
}