A critical assessment of the place of endoscopy in gastroenterology

Abstract

The introduction of the flexible fibrescope has been one of the most important advances in gastroenterology this decade. The fibrescope has virtually replaced the old rigid instrument and provides fuller information and is much safer. It is invaluable in detecting lesions in the fundus and antrum of the stomach and has provided the radiologists with a powerful stimulus to improve their techniques. It is important in the investigation of X-ray negative dyspepsia and acute upper gastrointestinal bleeding, and in assessing the post-operative stomach before further surgery is undertaken. The development of endoscopic retrograde cannulation of the pancreatic and common bile ducts is progressing rapidly and is certainly of great help in the elucidation of jaundice in difficult cases. Visualization of the jejunum from above and the ileum from below is still in the early stages but will be of help in the diagnosis particularly of Crohn’s disease of the ileum. The treatment of polyps in the colon has been revolutionized by the colonoscope and the number of laparotomies has been reduced by the development of endoscopic removal.