A one-year study of cholelithiasis at a tertiary care hospital of South India
DOI:
https://doi.org/10.18203/2349-2902.isj20182502Keywords:
Cholelithiasis, Laparoscopic cholecystectomy, Ultrasound abdomen, Wound infectionAbstract
Background: Gall stone disease is a chronic recurrent disease of hepatobiliary system characterised by formation of gall stones due to impaired metabolism of bile acids, cholesterol and bilirubin. The prevalence of cholelithiasis is variable and has been reported as 2-29% in India with differences in interstate and interregions. The objective of the present study was mainly focuses on the total clinical study with surgical management and their outcome.
Methods: A prospective study for a period of one year was done after approval from ethical committee. The socio-demographic factors, clinical history, physical examination, laboratory investigations with ultrasound abdomen were done in all the cases. Surgical repair by Laparoscopic and open cholecystectomy was done.
Results: Females were more predominant with male: female ratio of 1:1.97. Mean age of study population was 34.12±6.2 years and was more common during 5th decade of life. Pain in the hypochondrium was most common sign. Mixed stones were most common and mostly observed in cases of mixed diet. Laparoscopic cholecystectomy was most commonly performed with zero conversion rate. Wound infection was the most common post-operative complication in both the types of repair.
Conclusions: To conclude, from the present study females were more commonly affected by cholelithiasis than males with a ratio of 1:1.97. Females are more prone during fertile age and reasons are multifactorial due to hormones, parity and hormonal contraceptives. Gall stone disease is more common during fourth and fifth decade of life in both males and females. Mixed diet (non-vegetarian) is associated with increased risk of developing gall stones than vegetarian diet.
References
Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?. Curr Gastroenterol Reports. 2005;7(2):132-40.
David Q, Wang H, Nezam H. Afdhal. Gall stone Disease. Sleisenger Fordtran Gastrointestinal Liver Disease. 9th Edition;2010;1089-111.
Veerabhadrappa PS, Tank P, Singh A, Goel S, Nathwani P.A study of gall stone disease from a tertiary care center of Madhya Pradesh, India. Int Surg J. 2017;4:728-31.
Guss DA, Oyama LC. Disorders of the Liver and Biliary Tract. In: John Marx RH, Ron Walls, editors. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th edn. Philadelphia. 2010.
Sharma MP, Duphare HV, Nijhawan S, Dasarathy S. Gallstone disease in north India: clinical and ultrasound profile in a referral hospital. J Clinical Gastroenterol. 1990 Oct;12(5):547-9.
Unisa S, Jagannath P, Dhir V, Khandelwal C, Sarangi L, Roy TK. Population‐based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic basin of North India. HPB. J Int Hepato Pancreato Biliary Assoc. 2011;13(2):117-25.
Reddy BB, Agrawal RM. Goldwasser B. Biliary disease in the elderly. Geriatric Gastroenterol Series Practical Gastroenterol. 2008;32:14-2.
Singh V, Trikha B, Nain C, Singh K, Bose S. Epidemiology of gallstone disease in Chandigarh: A community‐based study. J Gastroenterol Hepatol. 2001;16(5):560-3.
Sharma MP, Duphare HV, Nijhawan S, Dasarathy S. Gallstone disease in north India: clinical and ultrasound profile in a referral hospital. J Clin Gastroenterol. 1990;12(5):547-9.
Sharadha B, Srinivas D. Clinical Study of Cholelithiasis. Int J Sci Stud. 2017;5(3):210-4.
Domeyer PJ, Sergentanis TN, Zagouri F, Tzilalis B, Mouzakioti E, Parasi A, et al. Chronic cholecystitis in elderly patients. Correlation of the severity of inflammation with the number and size of the stones. In Vivo. 2008;22(2):269-72.
Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F. Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr. 2004; 23 (3):187-96.
Mohan H, Punia RPS, Dhawan SB, Ahal S, Sekhon MS. Morphological spectrum of gallstone disease in 1100 cholecystectomies in North India. Indian J Surg. 2005;67:140-2.
Kapoor VK. Cholecystectomy in patients with asymptomatic gallstones to prevent gall bladder cancer-the case against. Indian J Gastroenterol. 2006;25:152-4.
