Diagnostic Value of Upper Gastrointestinal Endoscopy Prior to Cholecystectomy in a Tertiary Care Institute

ABSTRACT

Cholelithiasis is one of the most common problems encountered in surgery department. It has always been a challenge to distinguish upper gastrointestinal symptoms due to gall stones from other causes. The persistence of abdominal symptoms even after cholecystectomy is highly discouraging for surgeons.METHODSThis is a prospective study conducted on 50 cases at the Department of Surgery, MMU Hospital, Mullana among ultrasonographically proven gall bladder stones. After history taking and examination, all the patients were subjected to endoscopy 1-2 days prior cholecystectomy, and biopsies were obtained for histopathology if required.RESULTSOut of a total of 50 patients, 44 (88%) were females and 6 (12%) were males with a MF ratio of 322. 28 (56%) presented with typical pain and 22 (44%) presented with atypical pain. All patients were subjected to upper gastrointestinal endoscopy (UGE) and no lesion was found on endoscopy of 28 patients who presented with typical pain while out of 22 patients who presented with atypical pain, 18 (81.8%) had abnormal endoscopic finding and only 4 (18.2%) had normal endoscopy (p<0.001). Gastritis (72.2%) was the most common finding on upper gastrointestinal endoscopy followed by duodenitis (27.8%), oesophagitis (22.2%) and peptic ulcer (11.1%). On follow-up after 1 week of cholecystectomy all the patients except 10 from atypical group had persistence of preoperative symptoms.CONCLUSIONSPresence of atypical pain in patients with gall stones is highly likely to have other coexisting upper gastrointestinal pathologies. Hence, upper gastrointestinal endoscopy prior to elective cholecystectomy in patients with atypical presentation can be clinically helpful.