Volume : 7, Issue : 7, July - 2018

A Clinical Study on Role of Upper Gastrointestinal Endoscopy before Laparoscopic Cholecystectomy in a Secondary Care Centre

Dr Nagella Pradeep Kumar Reddy, Dr Bala Vidya Sagar, Dr S Sabu Jeyasekharan, Dr Deepak David

Abstract :

<p>&nbsp;Background: Cholelithiasis is one of the most common problems encountered in surgery. It‘s an immense</p> <div>challenge to discriminate between upper gastrointestinal (UGI) symptoms due to gall stones or any other causes.</div> <div>This study focuses on the role of upper gastrointestinal endoscopy as an investigative modality to 􀃶nd out other associated disorders of</div> <div>upper gastrointestinal tract in patients with ultra-sonogram proven gallstones presenting with dyspeptic symptoms.</div> <div>Methods: Patients included in the study were divided into two groups based on symptoms, Group A (typical symptoms) and Group B</div> <div>(atypical symptoms). All patients will be subjected to UGI endoscopy 1 or 2 days prior to operation and the endoscopic 􀃶ndings were noted</div> <div>.The patients who underwent cholecystectomy were followed up postoperatively on 7th, 14th, 30th day to evaluate the presence of any</div> <div>dyspeptic symptoms.</div> <div>Results: In present study we observed that, out of 92 patients, 37 were in typical group and 55 were in atypical group. All 92 patients</div> <div>underwent endoscopy before cholecystectomy. Out of 37 patients in typical group, 18 (48.60%) have positive 􀃶ndings. Out of 55 patients in</div> <div>atypical group, 42(76.40%) have positive 􀃶ndings with gastritis being the most common 􀃶nding in both groups. Out of 92 patients, 5 didn‘t</div> <div>undergo cholecystectomy and underwent different line of management. Patients were followed up postoperatively at day 7, 14 and 30.The</div> <div>reduction of pain was signi􀃶cant at day 30 with 2(5.56%) in typical group and 3(5.89%) in atypical group suffering with pain.</div> <div>Conclusions: Cholelithiasis can present with a complex combination of clinical symptoms which may resemble the presentation of other</div> <div>gastrointestinal diseases. Hence, the use of routine preoperative investigations like upper GI endoscopy prior to planning surgical</div> <div>treatment of cholelithiasis may help to identify other potentially treatable medical conditions and hence may reduce overall</div> <div>cholecystectomy rates.</div>