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.
Materials and 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.
Conclusion: 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.
