DOI: http://dx.doi.org/10.18203/2349-2902.isj20201536

The usage of prior upper gastrointestinal endoscopy among symptomatic patients undergoing cholecystectomy

Ayesha Jule Khan, Samridhi Gupta, Manu Kohli, Gopal S. Bhargava

Abstract


Background: Cholelithiasis is one of the most common problems encountered in surgery. It is an immense challenge to discriminate between signs and symptoms due to gastrointestinal lesions and gallstones diseases. The objective of this study was to evaluate the usage of pre-operative upper gastrointestinal endoscopy (UGE) as a routine in treating symptomatic gallstone patients.

Methods: This prospective hospital based observational study was conducted in the Department of General Surgery at Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar from January 2018 to June 2019. 60 symptomatic gallstone patients were selected for cholecystectomy and preoperative upper gastrointestinal (GI) endoscopy evaluation was done for any associated upper gastrointestinal problems.

Results: Out of the total patients, females constituted 85% of overall study patients and majority of the patients presented with atypical biliary colic symptoms (55%, group 2) whereas 45% presented with typical biliary colic symptoms (group 1) (p value=0.009). Relief rate was highest in group 1 with abnormal UGE than with group 2.

Conclusions: The routine use of upper GI endoscopy in patients with symptomatic cholelithiasis prior to cholecystectomy will help reduce post-operative persistence of symptoms and thus, it is a useful investigation in the overall treatment of gallstone diseases.

 


Keywords


UGE, Typical biliary colic, Atypical biliary colic

Full Text:

PDF

References


Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15(3):329-38.

Huang J, Chang CH, Wang JI, Kuo HK, Zin JW, Shan WY. Nationwide epidemiological study of several gallstone disease in Taiwan. BMC Gastroenterol. 2009;9:63-5.

Conlon K. The gall bladder and bile ducts. In: Williams NS, Bulstrode CJK, O’Connell PR. Bailey & Love’s Short Practice of Surgery. 25th ed. London: Edward Arnold; 2008: 119.

Desai HG, Pandit B. Treatment of asymptomatic gallstones. J Assoc Physicians India. 2003;51:999-1000.

Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder diseases in the United States. Gastroenterology. 1999;117(3):632-9.

Conte D, Fraquelli M, Giunta M, Conti CB. Gall stones and Liver disease: an overview. J Gastrointestin Liver Dis. 2011;20(1):9-11.

Berger MY, Hartman TC, Vander VJJM, Bohnen A. Is biliary pain exclusively related to gall bladder stone? A controlled prospective study. Br J Gen Pract. 2004;54(303):574-9.

Kraag N, Thijs C, Knipschild P. Dyspepsia - how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms and food intolerance. Scand J Gastroenterol. 1995;30(5):411-21.

Basselink MGM, Erpecum KJ. Biliary Colic is a valuable clinical descriptor for biliary pain due to “uncomplicated” gallstone disease. J Gastrointest Surg. 2009;13(9):1745-6.

Festi D. Clinical manifestations of gallstone disease: evidence from the multicenter Italian study on cholelithiasis (MICOL). Hepatology. 1999;30:839-46.

Diehl AK, Sugarek NJ, Todd KH. Clinical evaluation for gallstone disease: usefulness of symptom and signs in diagnosis. Am J Med 1990;89:29-33.

Lund J. Surgical indications in cholelithiasis: prophylactic cholelithiasis: prophylactic cholecystectomy elucidated on the basis of long-term follow up on 526 non-operated cases. Ann Surg. 1960;151:153-62.

Sabitha P, Ghouse Md, Nagamuneiah S. Esophagogastroduodenoscopy helpful to avoid unnecessary cholecystectomy. IOSR J Dent Med Sci. 2016;9(15):10-22.

Tsimoyiannis E, Antonio NC, Tsaboulas T, Papnikolaou N. Cholelithiasis during pregnancy and lactation. Eur J Surg. 1994;160:670-1.

Schofer JM. Biliary causes of post cholecystectomy syndrome. J Emerg Med. 2010;39(4):406-10.

Bates T, Ebbs SR, Harrison M, A'Hern RP. Influence of cholecystectomy on symptoms. Br J Surg. 1991;78(8):964-7.

Luman W, Adams WH, Nixon SN, McIntyre IM, Hamer-Hodges D, Wilson G, Palmer KR. Incidence of persistent symptoms after laparoscopic cholecystectomy: a prospective study. Gut. 1996;39(6):863-6.

Glambek I, Arnesjo B, Soreide O. Correlation between gallstones and abdominal symptoms in a random population - Results from a screening study. Scand J Gastroenterol. 1989;24(3):277-81.

Rassek D, Osswald J, Stock W. Routine gastroscopy before cholecystectomy. Chirurg. 1988;59(5):335-7.

Diettrich H, Wundrich B, Kobe E, Noack S, Weber K. Gastroscopy before cholecyscystectomy. Gastroenterol J. 1990;50(4):173-4.

Thybusch A, Schaube H, Schweizer E, Gollnick D, Grimm H. Significant value and therapeutic implications of routine gastroscopy before cholecystectomy. J Chir (Paris). 1996;133(4):171-4

Mozafar M, Sobhiyeh M, Heibatollahi M. Is esophagogastroduodenoscopy essential prior to the elective surgical therapy of symptomatic cholelithiasis? Gastroenterol Hepatol Bed Bench. 2010;3(2):77-82.

Karmacharya A, Malla BR, Joshi HN, Gurung RB, Rajbhandari M. The predictive value of preoperative symptoms including upper gastrointestinal endoscopy before laparoscopic cholecystectomy for elective symptomatic cholecystolithiasis. Kathmandu Univ Med J. 2013;44(4):300-4.

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;3:637-42.

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.

Srikantaiah HC, Manjappa VB. Diagnostic value of pre-operative upper GI endoscopy in gall bladder stone patients undergoing elective laparoscopic cholecystectomy. Int Surg J. 2019;6:2949-54.