Upper Gastrointestinal Surgical Unit, Royal Derby Hospital, Derby, DE22 3NE, United Kingdom.
Int J Surg. 2010;8(3):236-8. doi: 10.1016/j.ijsu.2010.01.008. Epub 2010 Feb 2.
A proportion of patients do not get symptomatic relief after cholecystectomy because there is an overlap in the symptomology of biliary and gasroduodenal pathologies. In our unit all the patients are offered gastroscopy prior to Cholecystectomy. Aim of this study was to evaluate the efficacy of gastroscopy in all patients with upper abdominal pain irrespective of ultrasound findings.
This retrospective study was carried out, between Jan 2001-Oct 2003. All the patients undergoing laparoscopic cholecystectomy by a single surgeon were studied. Group 1 (n = 61) were not endoscoped before the operation (Jan 2001-May 2002). Group 2 (n = 60) had routine endoscopy carried out before surgery (June 2002-October 2003). The results were entered in a database and analyzed.
Total of 240 laparoscopic cholecystectomies were carried out. Female to male ratio was 4:1. In Group 1, the recurrence or persistence of symptoms was 20/61 (32.78%) patients who were not scoped. In Group 2, all patients were scoped with positive findings in 35% of the patients. All were treated for the pathology and only 2(3.3%) had recurrence or persistence of symptoms.
The routine use of gastroscopy before laparoscopic cholecystectomy helps to reduce persistence of symptoms and is recommended.
由于胆系和胃肠疾病的症状有重叠，一部分患者在胆囊切除术后仍有症状未得到缓解。在我们科室，所有患者在接受胆囊切除术前都被建议行胃镜检查。本研究旨在评估胃镜检查在上腹部疼痛患者中的应用效果，无论其超声检查结果如何。
这是一项回顾性研究，于 2001 年 1 月至 2003 年 10 月进行。所有由同一位外科医生行腹腔镜胆囊切除术的患者都被纳入研究。组 1（n=61）患者术前未行胃镜检查（2001 年 1 月至 2002 年 5 月）。组 2（n=60）患者术前常规行胃镜检查（2002 年 6 月至 2003 年 10 月）。将结果输入数据库并进行分析。
共进行了 240 例腹腔镜胆囊切除术，男女比例为 4:1。组 1 中，20/61（32.78%）未行胃镜检查的患者术后症状复发或持续存在。组 2 中，所有患者均行胃镜检查，发现阳性结果的患者占 35%。所有阳性患者均针对其病理问题进行了治疗，仅有 2 例（3.3%）患者症状复发或持续存在。
腹腔镜胆囊切除术前常规行胃镜检查有助于减少症状持续存在的情况，因此推荐使用。
