Keywords
Cholecystectomy; Upper Gastrointestinal Endoscopy; Cholelithiasis
Abstract
Background: Symptomatic gallstones and inflammatory disorder of the gastro duodenum are common causes of upper abdominal pain. It’s a great challenge to differentiate between gastrointestinal symptoms due to gall stones or any other causes. These gastrointestinal symptoms may be related to gallstones but underlying correlation has not been established yet, which is extremely disappointing for the operating surgeon.
Aim: To find out role of preoperative endoscopy in symptomatic gall stones.
Methods: Prospective observational multicentre study of 382 patients undergoing Laparoscopic cholecystectomy from July 2014 to December 2015. All patients diagnosed with gallstones based on ultrasound abdomen, irrespective of age and sex. All patients were subjected to Upper Gastrointestinal Endoscopy 24 to 48 hours before cholecystectomy biopsy were obtained for histopathology if required. Those patients not keen for surgery, pregnant ladies due to risk of foetal loss, CBD stone, obstructive jaundice, carcinoma of gall bladder, was excluded
Results: During this period, 382 patients. The female to male ratio 4.78:1 (316 versus 66), and the mean patient age was 46.10 ± 6.31 years (22 to 65 years). 146 (38.21%) Patients were present with typical pain and 236 (61.78%) atypical pain. Ultrasound revealed single stone in 83 (21.72%), multiple stones in 299 (78.27%), impacted stone at the neck of gallbladder was found in 68 (17.80%) patients, Thick wall gallbladder was seen in 221 (57.85%) patients and contracted gallbladder 44 (11.51%) patients. Pre-operative upper gastrointestinal endoscopy findings revealed Esophagitis in 22 (5.75%) cases, GERD in 26 (6.80%) cases, gastritis in 88 (23.03%), gastric ulcer 49 (12.82%), duodenal ulcer in 39 (10.20%), polyps 21(5.49%) and carcinoma of stomach 9 (2.35%). In all patients with typical pain complete relief of symptoms were observed within 15days post- operatively. Out of 236(61.78%) cases with atypical pain had persistence of symptoms in 141 (59.74%) cases up to four months.
Conclusion: Upper Gastrointestinal Endoscopy should be performed preoperatively for gallstone disease to evaluate atypical symptoms and a patient is fully informed in addition treated for associated conditions.
Citation
Chandio A, Naqvi SA, Sabri S, Abbasi M, Shaikh Z, Chandio K, et al. Is it useful to Perform Preoperative Upper GI Endoscopy in Symptomatic Gall Stones? J Gastroenterol. 2018; 4(1): 1012.