CLINICO PATHOLOGICAL EVALUATION OF CHOLELITHIASIS AND MANAGEMENT STRATEGIES AT A TERTIARY CARE HOSPITAL

Dr.P.Muthalaisamy; Dr.K.Rajachidambaram; Dr.P.Karthick

Volume : VI, Issue : XII, December - 2017

CLINICO PATHOLOGICAL EVALUATION OF CHOLELITHIASIS AND MANAGEMENT STRATEGIES AT A TERTIARY CARE HOSPITAL

Dr. P. Muthalaisamy, Dr. K. Rajachidambaram, Dr. P. Karthick

Abstract :

Background: Cholelithiasis is a chronic recurrent disease of the hepatobiliary system. The impaired metabolism of cholesterol, bile acids and bilirubin are characterized by gallstone formation. The prevalence of cholelithiasis varies and has been reported as 2-29% in India, and increased in the recent years. In the present study, apart from studying the epidemiology i.e., demographic factors, dietary habits, clinical presentation, diagnostic tools and management, it also looks at the stone analysis and complications after surgery, in rural population in Southern India.

Material and Methods: A prospective cohort study undertaken at the department of Surgery a from September 2014 to October 2016. 104 patients fulfilling the inclusion criteria selected for the study after an informed consent has been obtained. Clinical symptoms were noted according to clinical history of the patients. An ultrasonography was done as confirmatory study and all patients underwent either open/laparoscopic cholecystectomy. Post operative complications and histopathological analysis of gallbladder along with chemical analysis of gallstones was carried out.

Results: The mean age of the patients was 43.56 years with a male-female ratio of

0.52:1. Pain flatulence and nausea/vomiting are the major clinical presentation of the gall stone. Multiple calculi were most frequently found in mixed type of stone while less in cholesterol while single calculi is more in mixed and less in pigmented type of stone. Wound infection was the commonest complication in open cholecystectomy group, and the mean hospital stay was significantly more in this group.