MVP Journal of Medical Sciences

Open Access Open Access  Restricted Access Subscription Access

A Clinical Study of Cholelithiasis at a Tertiary Health Care Centre


Affiliations
1 Professor and Head, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India
2 PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India
 

Introduction: Cholelithiasis is the most common disease state involving the gallbladder and biliary tree. Gallstones become symptomatic only when they obstruct a visceral structure. In developing countries, there exists a trend toward an increasing prevalence of the risk factors for gallstone disease. Materials and Methods: Cases were selected after applying inclusion and exclusion criteria. Thereafter data collection was done by meticulous history taking, clinical examination, appropriate laboratory and radiological investigations, operative findings, and post operative evaluation of cases. Results: This study comprised of 52 cases. Female to male ratio was 15:11. The most common presenting complaint was pain in abdomen in 49 (94.23%) patients. On clinical examination most common sign was tenderness in 48 (92.31%) patients. Abdominal ultrasonography showed gallstones in all cases. Either laparoscopic or open cholecystectomy was performed. Complications included wound infection, haemorrhage, and bile duct injury. On histo-pathological examination the most common finding was chronic Cholecystitis seen in 39 (75.00%) cases. Conclusion: The incidence of disease was more in females. The most common complaint was pain and the most common sign was tenderness. Abdominal ultrasonography should be imaging study of choice for suspected cases of cholelithiasis. Laparoscopic cholecystectomy is the procedure of choice.

Keywords

Cholecystectomy, Cholelithiasis.
Font Size

User
Notifications

  • Jackson PG, Evans SRT. Biliary system. In: Townsend Jr CM, Evers BM, Beauchamp RD, Mattox KL (Eds). Sabiston textbook of Surgery. 20th ed. Philadelphia: Elsevier Pub; 2017. p. 1482−519.

  • Conlon K. The gall bladder and Bile ducts. In: Williams N.S., Bulstrode C.J.K., O’Connell P.R. (Eds). Bailey & Love’s Short Practice of Surgery. 26th ed. Boca Raton: CRC Press; 2013. P. 1097−117.

  • Dutta U, Tandon R. Diseases of the Gall Bladder and Biliary Tract. In: Munjal Y, Sharma S, Agrawal A, Singal R, Gupta P, Sundar S et al (Eds). API Textbook of Medicine. 10th ed. Mumbai: The Association of Physicians of India; 2015. p. 1238−42.

  • Sun H, Tang H, Jiang S, Zeng L, Chen E, Zhou T, Wang Y. Gender and metabolic differences of gallstone diseases, World Journal of Gastroenterology. 2009 Apr 21; 15(15):1886−91. https://doi.org/10.3748/wjg.15.1886. PMid: 19370788, PMCid: PMC2670418.

  • Rachamalla RR, Markapuram KK, Satish S, Singh K. A one-year study of cholelithiasis at a tertiary care hospital of South India, Int. Surg. J. 2018; 5:2444−48. https://doi.org/10.18203/2349-2902.isj20182502.

  • Tafazal H, Spreadborough P, Zakai D. Laparoscopic cholecystectomy: A prospective cohort study assessing the impact of grade of operating surgeon on operative time and 30day morbidity, Ann. R. Coll. Surg. Engl. 2018; 100(3):178−84 https://doi.org/10.1308/rcsann.2017.0171. PMid: 29484945, PMCid: PMC5930083.

  • Naik JR, Surendar J. A clinical study of cholelithiasis. Paripex, Indian Journal of Research. 2017 Nov; 6(11). Cited on 2018 Nov 15. Available from: https://www.worldwidejournals.com/paripex/recent_issues_pdf/2017/November/November_2017_1509785939__23.pdf.

  • Kodama H, Kono S, Todoroki I, Honjo S, et al. Gallstone disease risk in relation to body mass index and waisttohip ratio in Japanese men, Int. J. Obes. Relat. Metab. Disord. 1999 Feb; 23(2):211−16. https://doi.org/10.1038/sj.ijo.0800781. PMid: 10078858.

  • Sharada B, Srinivas D. Clinical study of cholelithiasis, Int. J. Sci. Stud. 2017; 5(3):210−14. Available online at https://www.ijss-sn.com/uploads/2/0/1/5/20153321/ijss_jun_ oa42_-_2017.pdf.

  • Ganey JB. Cholecystectomy: Clinical experience with a large series, Am. J. Surg. 1986; 352−57. https://doi.org/10.1016/0002-9610(86)90466-6.

  • Sharma A. Towards a safer cholecystectomy-the fundus to porta approach, Indian J. Surg. 1997 Jun; 141−45.

  • Srinivasa Rao K, Ravi K. A prospective study on cholelithiasis and its complications, Journal of Dental and Medical Sciences. Dec. 2017; 16(12):01−04.

  • Attwood SE, Hill AD Hill, Mealy K, Stephens RB. A prospective comparison of laparoscopic versus open cholecystectomy, Annals of the Royal College of Surgeons of England. 1992; 74:397−400. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2497695/.

  • Kum CK, Wong CW, Goh PM, Ti TK. Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy, Surg. Laparosc. Endosc. 1994 Apr; 4(2):139−41.

  • Lujan JA, Parrilla P, Robles R, Marin P, Torralba JA, Garcia-Ayllon J. Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis: A prospective study, Archives of Surgery. 1998; 133(2):173−75. https://doi.org/10.1001/archsurg.133.2.173. PMid: 9484730.

  • Coccolini F, Catena F, Pisano M. Open versus laparoscopic cholecystectomy in acute cholecystitis, Systematic review and meta-analysis, Int. J. Surg. 2015 Jun; 18:196−204. https://doi.org/10.1016/j.ijsu.2015.04.083. PMid: 25958296.

  • Awasthi N. A retrospective histopathological study of cholecystectomies, Int. J. Health Allied Sci. 2015; 4:203−06. https://doi.org/10.4103/2278-344X.160902.

  • Catena F, Ansaloni L, Bianchi E, Di Saverio S, Coccolini F, et al. The ACTIVE (Acute Cholecystitis Trial Invasive Versus Endoscopic) Study: Multicenter randomized, doubleblind, controlled trial of laparoscopic versus open surgery for acute cholecystitis, Hepatogastroenterology J. 2013; 60(127):1552−56. Cited on 19 November 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24634923.


Abstract Views: 370

PDF Views: 103




  • A Clinical Study of Cholelithiasis at a Tertiary Health Care Centre

Abstract Views: 370  |  PDF Views: 103

Authors

Sudhir D. Bhamre
Professor and Head, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India
Ajit M. Dikle
PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India

Abstract


Introduction: Cholelithiasis is the most common disease state involving the gallbladder and biliary tree. Gallstones become symptomatic only when they obstruct a visceral structure. In developing countries, there exists a trend toward an increasing prevalence of the risk factors for gallstone disease. Materials and Methods: Cases were selected after applying inclusion and exclusion criteria. Thereafter data collection was done by meticulous history taking, clinical examination, appropriate laboratory and radiological investigations, operative findings, and post operative evaluation of cases. Results: This study comprised of 52 cases. Female to male ratio was 15:11. The most common presenting complaint was pain in abdomen in 49 (94.23%) patients. On clinical examination most common sign was tenderness in 48 (92.31%) patients. Abdominal ultrasonography showed gallstones in all cases. Either laparoscopic or open cholecystectomy was performed. Complications included wound infection, haemorrhage, and bile duct injury. On histo-pathological examination the most common finding was chronic Cholecystitis seen in 39 (75.00%) cases. Conclusion: The incidence of disease was more in females. The most common complaint was pain and the most common sign was tenderness. Abdominal ultrasonography should be imaging study of choice for suspected cases of cholelithiasis. Laparoscopic cholecystectomy is the procedure of choice.

Keywords


Cholecystectomy, Cholelithiasis.

References





DOI: https://doi.org/10.18311/mvpjms%2F2019%2Fv6i2%2F22955