Artikel
The role of routine esophagogastroduodenoscopy prior to laparoscopic cholecystectomy
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Veröffentlicht: | 24. April 2015 |
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Gliederung
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Introduction: Cholelithiasis can present with a complex combination of clinical symptoms, which may resemble the manifestation of other gastrointestinal diseases. The evidence for routine esophagogastroduodenoscopy (EGDS) before laparoscopic cholecystectomy is controversial. In our institution all the patients are offered EGDS prior to cholecystectomy.
Material and methods: A retrospective review on the significance of preoperative EGDS in 3196 patients who underwent laparoscopic cholecystectomy between January 2003 and December 2013 was conducted.
Results: EGDS was preformed in 3196 patients before surgery. Pathological findings were seen in 1585 (49.59%), 23,5% of the patients had gastritis, 0,6 % gastric ulcera, 0,8 % acute duodenal ulcera, 1,3 % Barrett’s esophagus, 5,5 % esophagitis, 0,03 % with gastric cancer, 0,2% portal hypertensive gastropathy and 12% hiatal hernias. Histological testing for Helicobacter pylori was done in 752 (23,5%) patients, a positive test was detected in 208 (27,7%).
Conclusion: EGSD is not generally required prior to cholecystectomy in patients with typical gallstone symptoms. Because of the high incidence of simultaneous upper gastrointestinal diseases, routine preoperative EGSD is indicated in patients with nonspecific upper abdominal pain and history of peptic ulcer disease.