A Clinical Study of Cholelithiasis at a Tertiary Care Teaching Hospital

Abstract

Introduction: Cholelithiasis (gallstone disease) is one of the most common hepatobiliary disorders worldwide. It is characterized by the formation of calculi (stones) within the gallbladder due to imbalances in the composition of bile. The condition ranges from asymptomatic gallstones to severe complications such as acute cholecystitis, pancreatitis, and obstructive jaundice. The incidence of bile stones in India is known to be around 4%. This incidence is 7 times higher among the Indians. The incidence in western countries is as high as 10-15%. Most of them are asymptomatic (>80%). Each year, about 1–2% of asymptomatic patients develop symptoms that necessitate surgery.

Aim: To study the incidence of cholelithiasis among patients attending a tertiary care teaching hospital. To study the age and sex distribution, various modes of presentations, types of gall stones, various treatments available and its outcome.

Material & Methods: A prospective observational study was conducted in the Department of General Surgery, Venkateshwara Institute of Medical Sciences, Gajraula. Over a period of Six Months consist of 30 cases were included in our study. Institutional Ethical committee permission was taken prior to the commencement of the study. Demographic data like age, sex, name, occupation are noted; clinical symptoms of presentation with duration, associated complaints, past medical and surgical history, personal history like diet history, OCP usage, alcohol ingestion, and family history will be noted.

Results: USG abdomen was the primary investigation of choice and was done for all the patients included in the study. Multiple stones in GB were the most common finding in this study account for 67% of patients. 30% of cases had single stone in GB. Thickened gall bladder wall was seen in 17% cases. 1 patient (3%) presented with Cholelithiasis with choledocholithiasis. Conclusion: Laparoscopic cholecystectomy is considered as the treatment of choice in these patients as it has better outcomes and is associated with fewer perioperative complications and morbidity in experienced hands. One should not hesitate to convert to an OC if significant adhesions or inflammation are identified during laparoscopy.