DOI: http://dx.doi.org/10.18203/2349-2902.isj20190815

Upper gastro-intestinal endoscopy prior to cholecystectomy, a necessity? an observational study in a tertiary care hospital in South India

B. N. Anandaravi, Faiyaz Abdul Jabbar

Abstract


Background: Cholelithiasis is the most common disease state involving the gallbladder and the biliary tree. Once the USG is reported as cholelithiasis, the patient is usually taken up for cholecystectomy. The patients with cholelithiasis usually present with upper gastro intestinal (UGI) symptoms which may also be attributed to other UGI pathologies. This study focuses on evaluating upper GI endoscopy as an investigative modality to diagnose other associated upper GI pathologies in patients with USG proven gallstones presenting with dyspeptic symptoms.

Methods: An observational study was undertaken over a span of 2 years, from June 2016 to May 2018. All the patients who presented with complaints of upper GI symptoms were subjected to undergo USG abdomen. The patients with positive USG findings for cholelithiasis were included and further evaluated by upper GI endoscopy.

Results: Out of 100 subjects evaluated during the study period, 58 were females and 42 males. The most common presenting symptom was heartburn (69%), followed by dyspepsia (58%), belching (56%) and nausea/vomiting (53%). Out of 100 patients 44 patients presented with biliary colic and nausea/vomiting (14%). 44 of the subjects were found to have normal mucosal study. Remaining 66% of the subjects had positive endoscopic findings. The most common endoscopic finding was gastro-esophageal-reflux-disease (GERD) (31%).

Conclusions: In this study it was found that 66% of the subjects had co-existing UGI pathologies. It is advisable to get UGI endoscopy routinely for patients being planned for cholecystectomy pre-operatively.


Keywords


Cholelithiasis, Cholecystectomy, GERD, Upper gastro-intestinal endoscopy

Full Text:

PDF

References


Conlon KCP. The gallbladder and bile ducts. In: Williams NS, O’connel PR, McCaskie AW, ed(s). Bailey & Love’s short practice of surgery. 27th ed. Boca Raton, FL: CRC press; 2018.

Auyang ED, Soper NJ. Cholelithiasis. In: Zinner MJ, Ashley SW, ed(s). Maingot’s Abdominal Operations. 12th ed. NewYork, NY: McGraw-Hill Medical; 2013.

Khedkar I, Prasad D, Datta A. Diagnostic value of upper gastrointestinal endoscopy prior to elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Int Surg J. 2018;5(1):105-09.

Kolla V, Charles N, Datey S, Mahor D, Gupta A, Malhotra S. Upper gastrointestinal endoscopy prior to laparoscopic cholecystectomy: a clinical study at a tertiary care centre in central India. Int Surg J. 2016;3(2):637-42.

Gadahire M, Pai A, Joshi M. Gastroscopic evaluation of patients with dyspeptic symptoms with incidental finding of cholelithiasis. Int Surg J. 2017;4(2):677-79.

Sabitha P, Ghouse M, Nagamuneiah S. Esophago gastro duodenoscopy helpful to avoid unnecessary cholecystectomy. J Dent Med Sci. 2016;15(9):10-22.

Mozafar M, Sobhiyeh MR, Heibatollahi M. Is esophagogastroduodenoscopy essential prior to the elective surgical therapy of symptomatic cholelithaisis? Gastroenterology and Hepatology From Bed to Bench. 2010;3(2):77-82.

Karmacharya A, Malla BR, Joshi HN, Gurung RB, Rajbhandari M. The Predictive Value of Pre-Operative Symptoms Including Upper Gastrointestinal Endoscopy Before Laparoscopic Cholecystectomy for Elective Symptomatic Cholecystolithiasis. Kathmandu Univ Med J. 2013;44(4):300-4.

Ibrahim MTMM, Khair RZAM, Mohamed EHY, Massaad AMM. Upper gastrointestinal endoscopic findings in patients with gallstone disease. Khartoum Med J. 2012;5(2):749-52.

Rajkumar KCM, Ramesh R, Ravichandran K. Upper GI Endoscopic Findings with Cholelithiasis. J Med Sci Clin Res. 2016;4(11):13817-9.

Kalpande S, Mondal A, Pandya J. Oesophagogastroduodenoscopy in patients with incidental cholelithiasis, its significance and therapeutic value: an observational study. Int Surg J. 2017;4(1):334-38.

Keerthi Rams MDRK, Baskaran R, Raja K, Prema M, Karthikeyan D. Upper GI endoscopic findings in patients with gallstone disease. Int. J. Modn. Res. Revs. 2015;3(10):997-8.