Diagnostic and prognostic role of upper gastrointestinal endoscopy in cholelithiasis patients with upper gastrointestinal symptoms

Abstract

Background: The aim of the present study was to find the utility of upper gastrointestinal (UGI) endoscopy in predicting the persistence of postoperative pain following laparoscopic cholecystectomy (LC) and to find the prevalence of other UGI pathologies before LC. Materials and Methods: Ninety patients ≥18 years of age who have gallbladder stones confirmed by ultrasonography were included in this prospective observational study. All patients were subjected to UGI endoscopy (UGIE) examination 1 day before operation. Postoperative follow-up was done on day 1, 14, and 30 for the symptoms. The primary outcome measure was the persistence of postoperative pain, whereas the secondary outcome measure was the prevalence of UGI pathology. The comparison of quantitative variables and qualitative variables was done using the unpaired Student's t-test and the Chi-square test/Fisher's exact test, respectively. Results: The majority of the patients (63.3%) had atypical symptoms. The incidence of the severity of postoperative pain at day 1, day 14, and day 30 did not differ significantly between typical symptoms group and atypical symptoms group. The postoperative pain at day 14 and day 30 was 62.9% versus 20.0% and 45.7% versus 5.5% in an abnormal UGIE group and normal UGIE group, respectively (P = 0.001 for both). In all 20 (22.2%), 9 (10.0%), 1 (1.1%), 2 (2.2%), and 3 (3.3%) had gastritis, deudenitis, gastric ulcer, deudenal ulcer, and gastrooesophageal reflux disease (GERD), respectively. Conclusions: Patients should undergo UGIE before LC to find the presence other UGI pathology.