DOI: http://dx.doi.org/10.18203/2349-2902.isj20192380

Cholelithiasis: causative factors, clinical manifestations and management

Renu Pimpale, Pradeep Katakwar, Murtaza Akhtar

Abstract


Background: Cholelithiasis is a common gastrointestinal disorder with an overall prevalence of 2-29%. This study aims to evaluate the evolution of demographic and etiological factors, the clinical manifestations of Cholelithiasis, the surgical management with its post-operative complications and the histopathological findings of the post-cholecystectomy specimen of gallbladder, in central India.

Methods: Patients symptomatic or asymptomatic diagnosed ultrasonically as cholelithiasis were included in the study and patients with primary choledocholithiasis were excluded.

Results: A total of 92 patients were enrolled, of which 62 (68.89%) were female, with mean age of 45.03yrs ± 13.59. Fifty four patients (58.69%) were having BMI >25. Pain was most common complaint seen in all patients. Jaundice was observed in 13 patients (14.13%) who had associated CBD calculus. Sickling was positive in 8.69% of patients. Lap cholecystectomy was done in 71 (77.17%) patients with a conversion rate of 6.57%. Nineteen (20.65%) were open cholecystectomy with or without CBD exploration and 2 underwent Lap cholecystostomy. Post operatively, surgical site infection was seen in 3 patients (4.22%) of laparoscopic cholecystectomy, 5 patients (26.31%) of open cholecystectomy and biliary leak was seen in 3 patients (15.78%) of open cholecystectomy. Histopathology of gallbladder was chronic cholecystitis in 70 patients (77.77%), malignancy was detected in 5 patients (5.55%) and Xanthogranulomatous cholecystitis in 2 patients (2.22%).

Conclusions: Cholelithiasis is commonly seen in females in 4th and 5th decade mainly presenting with abdominal pain and dyspepsia. Laparoscopic cholecystectomy offers best surgical management with lesser complications.


Keywords


Cholecystectomy, Cholelithiasis, Gallstones, Laparoscopy

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