Introduction: Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder disease and it is currently the most commonly performed major abdominal procedure in Western countries, most authors suggest that it’s safe to observe patients with asymptomatic gallstones, with cholecystectomy only being performed for those patients who develop symptoms. Fifteen percent of patients persist to have post cholecystectomy symptoms. This study aimed to evaluate the use of oesophagogastroduodenoscopy prior to laparoscopic cholecystectomy, and its impact on the management.
Method: This was a prospective clinical study involving patients with gallstone admitted to the Al-Basra Teaching Hospital, Department of General Surgery from January 2016 to December 2019. All patients were followed up from the time of admission until six months later. These patients were divided into seven groups according to age. All patients were having an abdominal ultrasound examination in order to diagnose the presence of cholelithiasis and to exclude other abdominal problems. All patients scheduled for laparoscopic cholecystectomy underwent upper GIT endoscopy preoperatively.
Results: A total of 1200 patient age range from 21 to 82 years were included (women, 83.33%, men, 16.66%) had cholelithiasis. Female to male ratio was 5:1. Positive endoscopic findings were observed in 380 (31.6 %) patients. The management plan was changed in these patients with positive findings by endoscopy and their surgery was postponed until they received proper treatment.
Conclusion: The routine use of oesophagogastroduodenoscopy prior to cholecystectomy would decrease the unneeded cholecystectomy in patients with cholelithiasis and positive endoscopic findings, which decrease post cholecystectomy persistence of symptoms.