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Abstract
Introduction: Cholelithiasis is a common gastrointestinal disorder frequently managed through laparoscopic cholecystectomy. Although it is effective in the management of cholelithiasis, the majority of patients, 10–40%, may still suffer from symptoms referred to as post-cholecystectomy syndrome (PCS). A significant number of these symptoms are associated with the undetected extra-biliary gastrointestinal pathologies. The purpose of this study was to examine the role of preoperative upper gastrointestinal endoscopy (UGE) in anticipating PCS in patients with cholelithiasis before cholecystectomy.
Methodology: A descriptive case series was carried out at Mayo Hospital in Lahore between November 2024 and April 2025. Sixty-five adult patients diagnosed with symptomatic cholelithiasis received preoperative UGE and were divided into two categories: Group A (normal UGE results) and Group B (positive UGE results). All participants subsequently underwent laparoscopic cholecystectomy and were monitored for six weeks to evaluate symptoms of PCS. Data analysis was performed using SPSS version 27, with statistical significance defined as p < 0.05.
Results: Of 65 patients, 36 were assigned to Group A and 29 to Group B. The incidence of PCS was higher in Group B than in Group A (37.9% vs 13.9%, p = 0.025). The predominant endoscopic findings included peptic ulcers (12.1%) and gastritis (9.1%). The most frequently reported PCS symptoms were abdominal pain (50%) and heartburn (37.5%). Among PCS patients, 25% had peptic ulcers and 18.7% had gastritis.
Conclusion: Preoperative UGE can effectively predict the probability of PCS by recognizing and managing concurrent upper gastrointestinal conditions. Routine UGE may improve postoperative outcomes and patient satisfaction by guiding comprehensive preoperative management.