STUDY ON CLINICOPATHOLOGY AND MANAGEMENT OF EXTRA HEPATIC BILIARY CALCULI

DR GORIJAVOLU SAI SREE KRISHNA; DR T J PRASANNA KUMAR

Volume : VII, Issue : V, May - 2018

STUDY ON CLINICOPATHOLOGY AND MANAGEMENT OF EXTRA HEPATIC BILIARY CALCULI

Dr Gorijavolu Sai Sree Krishna, Dr T J Prasanna Kumar

Abstract :

Introduction: Gallstone disease is the commonest disease involving biliary tract and is associated with significant morbidity and mortality so in this study we evaluated the age, sex incidence, most common etiological factors for extra – hepatic biliary calculi, illustrated the varying clinical presentations, studied the various modes of management adopted in our institution.

Material and methods: This study was conducted in NRI medical college, Department of General surgery and Gastroenterology between August2014 to August 2016. Patients admitted in various surgical units of our hospital were studied. A total of 60 patients were studied. A detailed history including dietary factors, life style habits, were elicited in all patients and thorough clinical examination was done in them. Various modalities of Investigations and treatment were carried out and analysis of the collected data was done.

Results: 60 i.e.0.4% of patients who were admitted under general surgery and surgical gastroenterology were studied. These 60 patients ranged between 16 and 62 years of age. The mean age was 45 years. The maximum number of cases occurred in the fourth and fifth decades.The female to male ratio was 3.6: 1.Abdominal pain, which was localized to right Hypochondrium was the major presenting symptom (90%).Out of 60 cases 51 (85%) of the cases had only GB calculi and 9 (15%) had CBD calculi.Clinical presentation of GB calculi in 51 cases was Acute cholecystitis in 3 (5.9%)cases, Chronic cholecystitis in 48 (94.1%).In patients with GB calculi (51), Various Surgical procedures performed were Emergency laparoscopic cholecystectomy in 3 cases, Elective cholecystectomy in 48 patients of which 39 were laparoscopic and 9 were Open (out of which 5 were lap converted to open).In 9 patients with CBD calculi, surgical procedures performed were (due to no availability of ERCP), Cholecystectomy with T tube drainage in 3 cases, Cholecystectomy with Choledochoduodenostomy in 3 cases, Cholecystectomy with Roux en Y choledochojejunostomy in 3 cases.

Conclusion: Laparoscopic cholecystectomy and open cholecystectomy have their advantages and disadvantages. Surgeon should have sound knowledge of the both ways so as to benefit the mankind in his best possible way.