Diagnostic Value of Upper Gastrointestinal Endoscopy Prior to Cholecystectomy

Gallstone disease remains one of the most common medical problems leading to surgical in‐ tervention. It occurs in up to 20% of men and 35% of women in Western societies [1, 2]. Ev‐ ery year, more than 500,000 cholecystectomies are performed in the US [3]. The resultant direct and indirect cost of gallbladder disease represents a consumption of ~$6.2 billion an‐ nually in the U.S., constituting a major health burden that has increased more than 20% over the last 3 decades [4]. Hence, the treatment of gallstones and its complications (cholecystitis, pancreatitis and bile duct obstruction) contributes substantially to healthcare costs [2]. The term “symptomatic gallstones” is widely used to describe symptoms arising secondary to presence of gallstones. There are wide range of gastrointestinal symptoms have been linked to gallstones but causal relationship has not been established yet [3, 5]. Although, gallstone disease is asymptomatic in the vast majority of individuals, it is commonly accepted that re‐ moval of the gallbladder is the best treatment for symptomatic gallstone disease [6]. Howev‐ er, less focus has been on patient selection and typical or common symptoms of this disease in order to understand prevailing symptoms after surgery. Cholecystectomy is a commonly performed abdominal surgical procedure performed for treatment of symptomatic gall‐ stones and prevention of complications. Nevertheless, given the high proportion of non-spe‐ cific abdominal symptoms in the people with known gallstones may lead to unjustifiable cholecystectomies [3, 7].