Routine endoscopy of the upper gastrointestinal tract in the evaluation of obstructive jaundice

Our experience with flexible end-viewing EGD in the patient with jaundice demonstrated an over-all low specificity (19 per cent) for clinically significant lesions in this patient population. The discovery of synchronous lesions of the upper gastrointestinal tract in 12 patients did not change our diagnostic or therapeutic planning. Therefore, we believe that there is little justification for the increased costs and patient discomfort involved in routine EGD which should be abandoned in instances of obstructive jaundice and should be used only when more specific indications for its use are present.