PRECHOLECYSTECTOMY ESOPHAGOGASTRODUODENOSCOPY - IS IT OF VALUE

Patients with cholelithiasis and history of atypical abdominal pain pr esent the surgeon with a challenging clinical problem. We hypothesized that preoperative esophagogastroduodenoscopy before cholecystectomy w ould identify patients with concomitant upper gastrointestinal patholo gy. Retrospective review of 143 patients who presented with atypical a bdominal pain, gallstones, and underwent EGD before their cholecystect omy between July 1989 and March 1994. A total of 1162 cholecystectomie s were performed during the study period; 143 patients (12 per cent) u nderwent a preoperative EGD because of atypical abdominal pain. One hu ndred ten patients (77 per cent) had normal endoscopies. Thirty-three patients (23 per cent) had abnormal findings. Gastric polyps were foun d in three patients and esophageal varices in one patient. There were 36 findings in 29 patients, which included peptic ulcer disease, esoph agitis, gastritis, and duodenitis. Seven patients had two abnormal fin dings. Moderate to severe disease was found in a total of 13 (9 per ce nt) patients. We recommend that patients who present with cholelithias is and atypical abdominal pain undergo preoperative esophagogastroduod enoscopy, as we have found that at least 9 per cent of the patient pop ulation will have significant findings that may alter their management .