Surveillance gastroscopy, defined as any gastroscopy performed within 3 months of the index examination to assess ulcer healing(1). Surveillance gastroscopy guidelines or recommendations for gastric ulcers vary among international gastroenterology societies. It is being done as per physician discretion and institutional recommendations. There is limited data on surveillance gastroscopy for gastric ulcer.

This retrospective study analysed data from our institutional endoscopy database (PACS2) between January 2016 and December 2023. Out of 144,947 gastroscopies performed, 3,348 patients had gastric ulcers, and 128 (3.8%) underwent surveillance gastroscopy within three months. The inclusion criteria were patients with gastric ulcers who underwent a surveillance gastroscopy and biopsy within 3 months of the first gastroscopy and were over 18 years of age.

The median interval for surveillance gastroscopy was 4.65 (3.1- 8.4) weeks. Male to female ratio is 1.84:1. Majority of the ulcers 85 (66.4%) were in the antrum. 72 (56.2%) of patients had ulcer size of less than 1cm. 119 (93%) of patients had regular border and 109 (85.2%) of patients had flat margins of the ulcer. Majority of the patients 41(32%) did not undergo biopsy during the initial scopy as they presented with an upper gastrointestinal bleed. Most of the ulcers 60 (46.8%) were healed on the surveillance scopy. Importantly, all the surveillance endoscopic biopsies done were benign.

There were no malignant cases diagnosed based on surveillance gastroscopy among the 128 patients, which is consistent with previous studies(2,3).

Surveillance gastroscopy did not have any additive value in diagnosing gastric malignancy. Further prospective multicenter studies are needed to validate these findings and establish definitive clinical conclusions..