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BACKGROUND Gallbladder stone disease is one of the most common problems encountered in surgical practice. The diagnosis of gallbladder stone disease has increased over the last decade because of the ease of access to sonography. A percentage of patients do not get relief after surgery for gallstone disease. The sonographic finding of gallbladder calculi may be incidental and acid peptic disease of the stomach or the duodenum, reflux disease or hiatus hernia may be the true cause of pain. Upper abdominal pain may be secondary to either cholelithiasis or gastro duodenal diseases. Differentiating between these two is important, because the prevalence of these conditions is common in the general population. Thus, this study aims to determine the importance of upper gastro intestinal endoscopy to reveal the association between dyspeptic symptoms and diseases with gallbladder calculi. METHODS This is a prospective study conducted on 66 cases of ultrasound proven gallstone disease, at the department of general surgery, Dr. Prabhakar Kore Hospital and Medical Research Center irrespective of age and sex. After examination, all patients were subjected to Upper GI endoscopy. The statistical analysis was conducted using SPSS version 22. RESULTS Out of 66 study samples, symptomatology has shown atypical biliary colic accounting for 54.5% in comparison to typical biliary colic of 45.5%. All subjects were subjected to upper GI endoscopy which detected a total number of 24 samples having positive upper GI lesions accounting for 36.4%, which is statistically significant (p=0.045) and 63.6 % being normal on endoscopy. CONCLUSIONS We recommend an UGI-Scopy pre-operatively for patients undergoing elective laparoscopic cholecystectomy for gallbladder stone disease for adequate diagnosis and treatment of the co-existing UGI lesions if present and reduce the incidence of post-operative persistence of symptoms. HOW TO CITE THIS ARTICLE: Bellad AKP, Asha MC. Role of pre-operative upper gastro-intestinal endoscopy in symptomatic patients undergoing elective laparoscopic cholecystectomy for gall bladder stone disease. J. Evolution Med. Dent. Sci. 2019;8(20): 1598-1601, DOI: 10.14260/jemds/2019/354 BACKGROUND Gallbladder stone disease is one of the most common problems encountered in surgical practice. Gallbladder calculi constitute a significant health problem in developed countries, affecting 10% to 15% of the adult population1. In Asia, the prevalence of gallstone disease is 5-10% of population especially among older individuals and females. The number of surgeries for Gallbladder stone disease has risen markedly in developed countries since 1950. The introduction of laparoscopic cholecystectomy in 1989 further increased the cholecystectomy rate.1 The diagnosis of gallbladder stone disease has steadily increased because of the common access to sonography. The vast majority of cholecystectomies are performed for gallbladder calculi with cholesterol stones accounting for nearly 75% of all gallstones.2 ‘Financial or Other Competing Interest’: None. Submission 01-04-2019, Peer Review 03-05-2019, Acceptance 09-05-2019, Published 20-05-2019. Corresponding Author: Dr. Manish Chandrashekar Asha, #135, 1st Main 2nd A Cross, Sadashivanagar, Belgaum-590010, Karnataka, India. E-mail: manishrules001@gmail.com DOI: 10.14260/jemds/2019/354 Gallstones are common the majority will be asymptomatic: up to 80% will never experience biliary colic or complications such as acute cholecystitis, cholangitis, or pancreatitis.3 Hence, most gallbladder calculi are clinically "silent" an incidental finding often uncovered during abdominal sonography being performed for another reason. Since most gallbladder calculi are asymptomatic, it is essential to define exactly which symptoms are caused by gallbladder calculi: true biliary colic and/or complications, versus vague abdominal complaints including dyspeptic symptoms. The importance for clarifying what constitutes true biliary colic is to better predict relief following surgery. Cholecystectomy proved successful in treating the patients of biliary colic and cholecystitis in 80-95% of patients with calculi. When calculi were not present, the presence of symptoms was as high as 40%.4 The persistence of abdominal symptoms even after cholecystectomy is highly discouraging for surgeons. Coexistence of concurrent upper gastrointestinal problems in gallbladder calculi patients may have attributed to the post cholecystectomy syndrome.5 Post-cholecystectomy syndrome (PCS) consists of a group of upper gastro-intestinal symptoms that recur and/or persist. After cholecystectomy. It is defined. as early if occurring in the post-operative period and late if it manifests after months or years. Although this term. Is used widely, it is not completely accurate as it includes a large number of Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN2278-4802, pISSN2278-4748/ Vol. 8/ Issue 20/ May 20, 2019 Page 1599 disorders, both biliary and extra-biliary in origin, that may be unrelated to surgery for cholelithiasis.6 To identify the cause of right upper abdominal pain, oesophagogastroduodenoscopy (Upper GI endoscopy) is important to identify the diseases of upper gastrointestinal tract. As it evaluates the mucosa for signs of disease from the esophagus through the duodenum & allows direct visualization of the ampulla Of Vater.7 These upper gastrointestinal symptoms have been. related to gallbladder calculi but causal relationship has not been established yet. Evaluation of gall stone disease is an immense challenge as to ascertain whether gallstones are responsible for symptoms or just an incidental finding and acid peptic disease of the stomach or the duodenum, reflux disease or hiatus hernia may be the true cause of pain. Thus, this study tries to seek the importance of upper gastro intestinal endoscopy to reveal the association between gastrointestinal symptoms and diseases with gallbladder calculi to establish a plan of treatment which is one of the most common problems faced by the current surgeon, for the complete cure of all patients. METHODS This is a hospital based one year, observational, crosssectional, hospital based, study conducted in KLES Dr. Prabhakar Kore Hospital. The study was conducted between January 2017 to December 2017. Source of Data All symptomatic patients getting admitted to the surgery wards, in KLES Dr. Prabhakar Kore Hospital with ultrasonographically proven Gall Bladder Stone Disease, who merit surgery. Inclusion Criteria All symptomatic patients having GB stone disease proven by ultrasonography who merit surgery.

journal of evolution of medical and dental sciences

ROLE OF PRE-OPERATIVE UPPER GASTRO-INTESTINAL ENDOSCOPY IN SYMPTOMATIC PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY FOR GALL BLADDER STONE DISEASE