Upper gastrointestinal endoscopy prior to laparoscopic cholecystectomy: a clinical study at a tertiary care centre in central India
Keywords:Cholelithiasis, Endoscopy, Dyspepsia, USG, Cholecystectomy
Background:Cholelithiasis is one of the most common problems encountered in surgery. It’s an immense challenge to discriminate between gastrointestinal symptoms due to gall stones or any other causes. These gastrointestinal symptoms have been related to gallstones but causal relationship has not been established yet, which is highly discouraging for the operating surgeon. An objectives of the study was to analyze the use of upper gastrointestinal endoscopy (UGE) as a pre-operative investigative tool in gallstone disease patients presenting with chronic dyspepsia.
Methods: This prospective observational study was conducted on 216 patients at Department of Surgery at Aurobindo PG institute. The data collected from the patients included personal information, presenting signs and symptoms, investigations including USG, UGE finding, biopsy reports if present, medications, surgery details, any post-operative complications. Statistical analysis done by chi-square test.
Results:Out of total patients, the mean age was 38.61 + 13.2 years. The male to female ratio was 1:3.one hundred and sixty (74.1%) patients had multiple stones. UGE showed a predominance of positive findings in group II with atypical symptoms than in group I (p-0.004). Therapeutic approach was changed in a total of 10 (4.6%), who were diagnosed with ulcer, malignancy and celiac disease. Cholecystectomy was performed in 206 (95.4%) patients. The relief rate is highest in group I with negative UGE than with group II.
Conclusions:Besides its cost effectiveness, UGE is potentially helpful in reducing the incidence of postoperative persistence of symptoms. Thus UGE has a vital role in the initial evaluation and investigation of patients with symptomatic gallstone patients.