Role of Routine Preoperative Upper Gastrointestinal Endoscopy in Symptomatic Cholelithiasis: A Prospective...

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Symptomatic cholelithiasis (gallstones) often presents with dyspeptic symptoms.
• Concurrent upper gastrointestinal (UGI) conditions can complicate diagnosis and treatment of gallstone disease.

Purpose of the Study:

• To determine the prevalence of concurrent UGI conditions in patients with symptomatic gallstones.
• To evaluate the impact of preoperative UGI endoscopy on patient management and outcomes.

Main Methods:

• A prospective observational study of 103 patients with symptomatic cholelithiasis.
• All patients underwent preoperative UGI endoscopy.
• Treatment was categorized based on endoscopic findings: cholecystectomy, cholecystectomy with medical treatment, or postponed surgery.

Main Results:

• Significant UGI pathologies were identified, including esophagitis (30.1%), hiatus hernia (18.4%), and gastric erosion (18.4%).
• Preoperative endoscopy altered management in 58.3% (cholecystectomy) and 38.8% (cholecystectomy with medical treatment) of cases.
• Mean symptom scores significantly decreased postoperatively in treated groups.

Conclusions:

• A high incidence of concurrent UGI pathology exists in patients with symptomatic gallstones and dyspepsia.
• Preoperative endoscopy is valuable for identifying these conditions, altering management, and potentially improving symptom resolution.
• Routine preoperative endoscopy may reduce persistent postcholecystectomy symptoms.