The Impact of Routine Oesophagogastroduodenoscopy on the Management Plan Before Cholecystectomy: A Prospective Study

*Ahmed Z Khalaf Al-Eass
Department Of General Surgery, Al-Basra Teaching Hospital, University Of Basra, Basrah, Iraq

*Corresponding Author:
Ahmed Z Khalaf Al-Eass
Department Of General Surgery, Al-Basra Teaching Hospital, University Of Basra, Basrah, Iraq
Email:Ahmed.Khalaf@uobasrah.edu.iq

Published on: 2021-04-02

Abstract

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.

Keywords

Cholecystectomy, Endoscopy Before Cholecystectomy, Laparoscopic Cholecystectomy, Management of Cholelithiasis

Introduction

Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder disease and it’s currently the most commonly performed major abdominal procedure in Western countries [1-3]. Laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones and has become the treatment of choice for many patients [4-9].

Most authors would suggest that it’s safe to observe patients with asymptomatic gallstones, with cholecystectomy only being performed for those patients who develop symptoms or complications of their gallstones [7]. Laparoscopic cholecystectomy is the procedure of choice for the majority of patients with gallbladder disease [1-9].

In 15% of patients, cholecystectomy fail to relieve the symptoms for which the operation was performed, such patients may be considered to have a post-cholecystectomy syndrome [10,11]. However, such problems are usually related to the preoperative symptoms and are merely a continuation of those symptoms [1,12]. This study aimed to evaluate the use of oesophagogastroduodenoscopy prior to laparoscopic cholecystectomy, and its impact on the management plan of patients with symptomatic gallstones.

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