Upper gastrointestinal endoscopy in surgical practice.

The use of fiberoptic endoscopy provides an accurate diagnosis in more than 90% of patients with lesions in the oesophagus, stomach and proximal duodenum. It is, however, an expensive and time-consuming investigation and is not always necessary when a satisfactory diagnosis has been made after radiological examination. Groups of patients have now been identified in which endoscopy is of particular value to the surgeon. When there is doubt about the diagnosis after radiological examination, particularly regarding the malignancy of a gastric ulcer, when an upper gastrointestinal haemorrhage occurs, when postgastrectomy patients present with symptoms, and when persistent symptoms occur in the absence of radiological findings, endoscopy is mandatory for an accurate diagnosis to be achieved and rational treatment instituted.