الفهرس 
Acknowledgements
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Abstract
Gastroesophageal varices are the most common lethal complication of liver cirrhosis because their rupture results in variceal hemorrhage. Gastroesophageal varices are present in approximately 50% of patients with cirrhosis.
The gold standard in the diagnosis of varices is esophago-gastroduodenoscopy (EGD).
The objective of therapy for patients at an early stage is to prevent the development of later stages.
Our purpose is to evaluate the endoscopic performance among physicians and their adherence to the previously mentioned guidelines, so from 2017 to 2018, questionnaire about this issue was distributed among different universities in upper Egypt.
There is no significant difference between duration of experience, speciality (gastroenyerology, internal medicine), age and score of adherence.
There is statiscally difference between male and female regarding their adherence to the guidelines with mean SD 16.03 to male and 12,56 to females.
So in conclusion the value of our study and the value of assessing physicians` performances in endoscopic field is to make sure that all physicians follow the guidelines to accomplish the optimum benefit to the patient and to improve his outcome, so to achieve this results we can use several methods as printing the recent guidelines in every endoscopic unit, continuous supervision from the experienced physicians to those who still gaining experience in the field, also intensive training course followed by clinical and academic test to evaluate the trainer before giving him the licensee to the perform upper endoscopy on his own.