Evidence map›Paper›PMID 40021605›Full record

ArticleDigestive diseases and sciences2025

Optimal Sequencing in Same-Day Bidirectional Endoscopy: A Tertiary US Healthcare Center Experience.

Arjun Chatterjee, Renan Prado, Zurabi Zaalishvili, Jacqueline Estevez, Rocio Lopez, John McMichael, John J Vargo, Prabhleen Chahal, Jean-Paul Achkar, C Roberto Simons-Linares

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Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Arjun ChatterjeeDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Renan PradoDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Zurabi ZaalishviliDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Jacqueline EstevezDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Rocio LopezQuantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
John McMichaelDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
John J VargoDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Prabhleen ChahalDepartment of Gastroenterology, Hepatology and Nutrition, University of Texas at San Antonio, San Antonio, TX, USA.
Jean-Paul AchkarDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
C Roberto Simons-LinaresDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA. simonsc@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSame-day performance of esophagogastroduodenoscopy (EGD) and colonoscopy is called bidirectional endoscopy (BDE). BDE is commonly performed, but the optimal sequence for which procedure to do first is not well established. This is the first study in the US to investigate the optimal sequence for BDE.

methodsWe performed a cohort study of patients with same-day BDE (2003-2018) at our institution. The two study groups were (1) EGD followed by colonoscopy (UL) and (2) Colonoscopy followed by EGD (LU). Endpoints included procedure duration, extent reached, sedation, and diagnostic yield.

results22,905 patients underwent BDE, with complete data available for 16,538. 14,325 underwent UL, and 2213 underwent LU. For diagnostic indications, the LU group was more likely to require opiates (OR 2.8, CI 2.5-3.3, p < 0.001), benzodiazepines (OR 3.0, CI 2.6-3.4, p < 0.001), antihistamines (OR 1.5, CI 1.2-1.8, p < 0.001), while less likely to require anesthesia (OR 0.33, CI 0.28-0.39, p < 0.001). Similar results were found for surveillance indication of endoscopy and in screening colonoscopy, with no differences in EGD screening indications. Total Procedure duration: UL had shorter total procedure duration (23.2 vs. 28.8 min; p < 0.001), EGD duration (5.4 vs. 6.5 min; p < 0.001), and colonoscopy duration (17.9 vs. 22.3 min; p < 0.001). Diagnostic yield: UL and LU sequences had comparable polyp detection rates (37.6% vs. 38.1%, p = 0.65) with similar adenoma detection rates (ADR).

conclusionPerforming EGD first resulted in shorter procedure times and a reduced likelihood of requiring opioids and benzodiazepines, with no differences regarding procedure-related adverse events or diagnostic yield.

Indexed as

ColonoscopyEndoscopy, Digestive SystemAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTertiary Care CentersTime FactorsUnited StatesBidirectional endoscopyOptimal endoscopy sequenceSame-day EGD and colonoscopySame session EGD and colonoscopy

Identifiers

PMID40021605
PMCPMC12125059

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