Role of upper gastrointestinal endoscopy prior to cholecystectomy to assess the postoperative outcome

Abstract

The aim of the study is to identify UGI pathologies in patients with cholelithiasis and association of these pathologies with a relief of symptoms in cholecystectomy patients. The study was conducted in 150 patients, who attended the surgical outpatient block or referred to our department from other departments and also known case of cholelithiasis by imaging studies. They were divided into a typical or atypical group based on their symptomatic presentation. UGI scopy was done on these groups, 2 days prior to surgery. Post operatively patients were followed up on 7^th, 21^st and 42^nd day and pain if any was assessed by NRS scaling method. Following results were noted. A female preponderance was seen (96 (64%)). Determining on age, 51 % of cases were seen among 31-50 years. UGI scopy revealed UGI pathologies in 22 among 92 (24%) patients who had typical symptoms of biliary colic, while 47 of 58 (81%) atypical presentations had UGI pathologies. The most common UGI pathology was gastritis and duodenitis (42 of 69 (61%)). Medical management was initiated for these pathologies prior to surgery. Postoperatively on 7^th  day 114 (76%) had no symptoms and 36 (24%) were symptomatic,  of which 25 (69.4%) of them were UGI Positive preoperatively. Medical Management for their Gastrointestinal pathologies was continued and reviewed on 21^st day of surgery which showed symptom relief in 31 of 36 patients (86.1%) and relief of symptoms in remaining 5 by 42^nd day of surgery. Hence, this study recommend preoperative UGI scopy in cholelithiasis, which will help in postoperative management.