| Abstrakt: |
Aim: Role of Upper gastrointestinal endoscopy prior to laparoscopic cholecystectomy. Methods: A total of 170 patients were included in the study who were divided in to two groups based on symptomatology, first group (N-70) in which patient present with typical symptoms of biliary colic and second group (N-100) in which patients present with atypical symptoms. Patients of gall bladder stones as demonstrated on ultrasound, which are willing to participate in the study. Patients presenting with any one of the following symptoms pain or discomfort in upper abdomen, nausea or vomiting, early satiety, bloating or fullness of abdomen were included in this study. Results: UGE showed a predominance of positive findings in group II rather than group I, i.e. atypical greater than typical group(p-0.004) Patients with a clear cut history of previous attack of cholecystitis 53 (75.71%) of patients in group I and 40(40%) of patients in group II. UGI endoscopy findings, Out of 70 patients, and 33 (47.14%) patients showed normal findings and 47 (52.86%) patients showed abnormal findings in group I with atypical symptoms and patients were subjected to biopsy in case of ulcer or any abnormal pathology. Most common findings being the gastritis (30%), hiatus hernia (10%), duodenitis (10%), reflux oesophagitis (7.14%), gastric ulcer (1.43%), duodenal ulcer (1.43%), others including gastric polyp and gastric tumors (2.86%), with histopathological finding suggestive of Helicobacter pylori related ulcers in stomach and duodenum, carcinoma stomach. UGI endoscopy findings, Out of 100 patients, 30(30%) patients showed normal findings and 70(70%) patients showed abnormal findings in group II with atypical symptoms subjected to biopsy in case of ulcer or any abnormal pathology. Most common being the gastritis(41%), hiatus hernia (31%), duodenitis (15%), reflux oesophagitis (10%), gastric ulcer (3%), duodenal ulcer (2%), others including candidialoesophagitis and celiac disease (3%), with histopathological finding suggestive of H.pylori related ulcers in stomach and duodenum and celiac disease. The therapeutic approach was changed in a total of 9(5.29%) out of which 4 patients were diagnosed with ulcer and malignancy in pathological reports in group I and 5 who were diagnosed ulcer and celiac disease in group II. Cholecystectomy was performed in 161 (94.71%) patients. Conclusion: Pre-elective and routine use of UGE before laparoscopic cholecystectomy helps in reducing persistence of symptoms and in treatment management. [ABSTRACT FROM AUTHOR] |
