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Journal of Gastronenterology and Digestive Diseases | Volume 3
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
GASTROENTEROLOGY
International Conference on
Ashfaq Hussain Chandio et al., J Gastroenterol Dig Dis 2018, Volume 3
IS IT USEFUL TO PERFORM
PREOPERATIVE UPPER GI ENDOSCOPY
IN SYMPTOMATIC GALL STONES?
Ashfaq Hussain Chandio1, Abbasi M2, Chandio K3,4, Memon A3,4
and Naqvi SA1
1Tameside NHS Foundation Trust Hospital, UK
2Liaquat University of Medical & Health Sciences, Pakistan
3Shaheed Mohtarama Benazir Bhutto Medical University, Pakistan
4Chandka Medical College Larkana, Pakistan
Background: Symptomatic gallstones and inflammatory disorder of the
gastro duodenum are common causes of upper abdominal pain. It’s a great
challenge to differentiate between gastrointestinal symptoms due to gall
stones or any other causes. These gastrointestinal symptoms may be related
to gallstones, but underlying correlation has not been established yet, which
is extremely disappointing for the operating surgeon
Aim: To find out role of preoperative endoscopy in symptomatic gall stones
Methods: Prospective observational multicentre study of 382 patients
undergoing Laparoscopic cholecystectomy from July 2014 to December
2015. All patients diagnosed with gallstones based on ultrasound
abdomen, irrespective of age and sex. All patients were subjected to Upper
Gastrointestinal Endoscopy 24 to 48 hours before cholecystectomy biopsy
were obtained for histopathology if required. Those patients not keen for
surgery, Pregnant ladies due to risk of foetal loss, CBD stone, obstructive
jaundice, carcinoma of gall bladder, were excluded.
Results: During this period, 382 patients. The female to male ratio 4.78:1
(316 versus 66), and the mean patient age was 46.10±6.31 years (22 to
65 years). 146 (38.21%) Patients were present with typical pain and 236
(61.78%) atypical pain. Ultrasound revealed single stone in 83 (21.72%),
multiple stones in 299 (78.27%), impacted stone at the neck of gallbladder
was found in 68 (17.80%) patients, Thick wall gallbladder was seen in 221
(57.85%) patients and contracted gallbladder 44 (11.51%) patients. Pre-
operative upper gastrointestinal endoscopy findings revealed Esophagitis in
22 (5.75%) cases, GERD in 26 (6.80%) cases, gastritis in 88 (23.03%), gastric
ulcer 49 (12.82%), duodenal ulcer in 39 (10.20%), polyps 21(5.49%) and
carcinoma of stomach 9 (2.35%). In all patients with typical pain complete
relief of symptoms were observed within 15 days post- operatively. Out of
236(61.78%) cases with atypical pain had persistence of symptoms in 141
(59.74%) cases up to four months.
Conclusion: We conclude that upper gastrointestinal endoscopy should be
performed preoperatively for gallstone disease to evaluate preoperatively
atypical symptoms and patients is fully informed in addition treated for
associated conditions.
Ashfaq Hussain Chandio is a surgeon special-
izing in general surgery. He is employed by the
NHS Trust. He is graduated from Chandka Med-
ical College Larkana in 1988. He has obtained
his training in various specialities of general
surgery (General Surgery, Urology, Emergency
medicine, Vascular, Breast & Endocrine, and
Colorectal) in Ireland and UK. He is awarded as
FEBS/Coloproctology in 2018 by European Sur-
gical (Coloproctology) Board. He has obtained
comprehensive training in general surgery. He
routinely performs general surgical operations
in NHS hospital. He also actively participates
in the teaching of medical students and junior
doctors.
BIOGRAPHY