Abstract
Background: The study was conducted to analyze the clinical presentation, incidence and variations of presentation among the various age/sex groups and the various mode of management of Cholelithiasis.
Methods: This study was conducted in our hospital in the department of General surgery, from October 2016 to September 2018, among 50 patients who were presented at the hospital with symptoms and signs suggestive of Gallstones and diagnosed by radiological and laboratory evidences as Cholelithiasis. The management of the disease, and postoperative complications and histopathological evaluation of the specimen were done and the results were correlated with various other studies.
Results: The most age group affected is between 17 and 79 years. Almost all patients had right hypchondrial pain and dyspepsia. By USG abdomen 100% of the patients confirmed the diagnosis of cholelithiasis. Mean age of the patient was 48 years in our study. Mixed type of gall stones were being the most common. Next in the list being cholesterol stones and pigment stones follow them. 52% of the patients were female. All the 50 patients were treated surgically, 39 open cholecystectomy and 11 laparoscopy cholecystectomy. All 50 gall bladders sent for HPE, out of which 49 reported as chronic cholecystitis and 1 reported as adenocarcinoma.
Conclusion: Cholelithiasis is most commonly found as incidental finding in USG especially in 4th or 5th decade of age. Among the symptomatic patients, after confirmation with USG, surgery was planned. Laparoscopic Cholecystectomy is the management of choice.
Keywords: Cholelithiasis, Cholecystectomy, Gallstones, Laparoscopy.
References
- Park K, editor. Man and medicine towards health for all. Park’s Text book of Preventive and Social Medicine. 17th Jabalpur: Banarasi Das; 2002. P 1-10
- Tandon RK. Diseases of gallbladder and biliary tract. In: Shah SN, editor. API Textbook of Medicine. 7th Mumbai: Association of Physicians of India; 2003. p. 642-4
- Saunders KD, Cates JA, Roslyn JJ. Pathogenesis of gallstones. SurgClin North Am 1990;70:1197-216.
- Karan JA, Rose GJ. Cholelithiasis and cholecystectomy. In: Zynnel MJ, Schwartz SI, editor. Maingot’s Abdominal Operations. 10th , Vol. 2. New York: Harold Ellis; 2001. p. 1717-38.
- Blumgart LH. Gallstones and gallbladder. In: Blumgart LH, Fong Y, editors. Text Book of Surgery of Liver and Biliary Tract. Vol. 1. London: Harcourt Publishers; 2002. p. 617-791.
- Talamini MA, Gadacz TR. Gallstone dissolution. SurgClin North Am 1990;70:1217-30.
- Bannister LH, editor. Bile duct and gallbladder. Gray’s Anatomy. 38th Boca Raton: Martin Berry; 2000. p. 1809-12.
- Oddsdottir M, Hunter JG. Gallbladder and extra biliary system. In: Brunicardi FC, editor. Schwartz’s Principles of Surgery. 8th McGraw- Hill Publication; 2005. p. 1187-221.
- Gordon KC. A comparative anatomical study of the distribution of the cystic artery in man and other species. J Anat 1967;101:351-359.
- Mincsev M. Bilocular gallbladder. Orvoskepzes 1967;42:286-98.
- McSherry CK. Cholecystectomy: The gold standard. Am J Surg 1989;158:174-8.
- Morgenstern L, Wong L, Berci G. Twelve hundred open cholecystectomies before the laparoscopic era. A standard for comparison. Arch Surg 1992;127:400-
- Besen EA, Page RE. A practical reappraisal of the anatomy of the extrahepatic bile ducts and arteries. Br J Surg Endosc 1995:1081-4.
- Rocko JM, Swan KG, Di Gioia JM. Calots triangle revisited. Surg Gynecol Obstet 1981;153:410.
- Specint MJ. Calots triangle. JAMA 1967;200:1186.
- Saha M, Nahar K, Hosen MA, et al. Prevalence and Risk Factors of Asymptomatic Gallstone Disease in North-East Part of Bangladesh. Euroasian Journal of Hepato-Gastroenterology. 2015;5 (1):1-3. doi:10.5005/jp-journals-10018-1118.
Corresponding Author
Dr Mohan. C. P
No. 329, PG Men’s Hostel, Annamalai Nagar, Annamalai University, Chidambaram – 608002, India
Ph No: 9500162223. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.128
