Esophagogastroduodenoscopy prior to laparoscopic cholecystectomy.
BACKGROUND
Peptic ulcer disease and gallstones are common causes of upper abdominal pain. The benefits of routine gastrostroscopy before laparoscopic cholecystectomy have been controversial. Some cases of persistent abdominal pain after laparoscopic cholecystectomy have been attributed to peptic ulcer disease.


METHODS
We reviewed the significance of preoperative esophagogastroduodenoscopy in patients scheduled for laparoscopic cholecystectomy. We compared a group of patients who underwent esophagogastroduodenoscopy before laparoscopic cholecystectomy and a group of patients who underwent laparoscopic cholecystectomy with no preoperative esophagogastroduodenoscopy. Postoperative residual abdominal pain, esophagogastroduodenoscopy findings, hospital stay, and other variables were examined.


RESULTS
There were 400 patients in this study: 218 (54.5%) patients underwent esophagogastroduodenoscopy while 182 (45.5%) did not. The mean age was 49.8 years, 311 were female and 89 were male patients. One hundred and twenty seven (31.7%) patients were diagnosed with acute cholecystitis and 273 (68.2%) were nonacute. In the esophagogastroduodenoscopy group, there were normal findings in 98 (45%) patients. Disorders such as hiatus hernia (21%), acute duodenal ulcers (3.6%), esophagitis (3.6%), gastric ulcer (0.4%), and Barrett's esophagus (0.4%) were among the findings. Laparoscopic cholecystectomy was avoided in six patients with chronic cholecystitis. Preoperative esophagogastroduodenoscopy did not reduce the incidence of postoperative residual abdominal pain; in fact, patients who underwent esophagogastroduodenoscopy had longer hospital stays (P = 0.02). Unlike chronic cholecystitis, esophagogastroduodenoscopy did not change the course of the planned surgery in acute cholecystitis.


CONCLUSIONS
Esophagogastroduodenoscopy prior to laparoscopic cholecystectomy does not have an impact on postoperative residual abdominal pain; however, it can disclose other gastroesophageal disorders with similar symptoms to gallstones and may change the course of the planned surgery in chronic cholecystitis.
Al-Azawi
Dhafir
D
Department of Surgery, Tullamore Regional Hospital, University College, Dublin, Ireland. dhafir66@hotmail.com
Rayis
Abubakir
A
Hehir
Dermot J
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome