PWE-046 Most referrals for gastroscopy (ugie) in freetown, sierra leone (sl) have benign disease though in some, there was a need to disprove recently diagnosed malignancy – preliminary results from freetown ugie training project

IntroductionEndoscopy services are rudimentary in SL with no formally accredited endoscopists and a single Olympus stack and gastroscope.Supported by a grant from the British Society Of Gastroenterology (BSG) we delivered a training program in UGIE to 4 postgraduate doctors and 3 nursing assistants (7 trainees). We aim to develop a comprehensive database over the next 12 months and here give the findings in the initial cases.Method4 UK accredited trainers; DN, JH, CM and CW visited SL in 11/2016 and delivered a 3 day course for the 7 trainees. Whole team were taught essentials of scope handling and disinfection, patient safety monitoring and basic life support. The nurses were taught to support patient head and reassure the patient, monitor vital signs and give reports to the endoscopist. Trainee doctors were supported in performing 3 UGIE each during the course and taught to observe and give feedback to each other using the UK Direct Observation of procedural skills (DOPS) forms. They performed subsequent procedures together; 1 performing the UGIE, 1 acting as supervisor and 1 recording a video. Videos were sent to trainers in UK with patient consent, findings confirmed and feedback given. Reports recorded on ADAM database (Fujifilm), which was analysed for this report, together with the videos.ResultsThere have been a total of 31 procedures performed, 14 on the course rest by 3 of the 4 trainees, working together as described. Clinical data reported in Table 1ConclusionWe have developed a system of effectively monitoring performance of safe UGIE remotely with local colleague support, helping with patient management.Similar to other areas of the world, majority of patients with dyspepsia without alarm symptoms have been shown to have benign pathology or normal UGIE.Also, importantly, we downgraded the previous misdiagnosis of cancer in two males in their 40s.We feel that these findings support the BSG assisted project to develop UGIE services as a helpful development in Sierra LeoneAbstract PWE-046 Table 1Main FindingNumberReferral reason(s) Normal gastroscopy15All referred for dyspepsia or abdominal pain. 3 with reflux. No alarm symptoms.1 with recent OGD – GASTRIC CANCERMild erythematous gastritis1Recent OGD – GASTRIC CANCERPeptic disease – GU/DU/erosive gastritis or duodenitis11Dyspepsia +/- vomiting. 1 patient with weight lossPyloric obstruction –aetiology yet undetermined2Vomiting, anorexia and weight lossSevere caustic oesophagitis1Caustic ingestion