Abstract
Background: Cholelithiasis, is a recurrent disease caused due to impaired cholesterd, bilirubin and bile acid metabolism. It has high prevalence in southern part of India than in comparison to northern part. Therefore the aim of our study was to study the incidence of cholelithiasis in Population of Rajasthan and its associated risk factors along with surgical management and complication.
Materials & Methods: The study was conducted in the department of surgery, Government Bangur Hospital, Pali, Rajasthan (India) taking 80 patients. Patient history was taken in the structured proforma. The ultrasonography of the abdomen and surgical procedure (Both laparoscopy and open) were carried out.
Results: Cholelithiasis was more prevalent in female (68.75%) and was frequent in the age group and 40-50 years (31.25%). Mixed type of calculi was more common (66.25%). The major sign observed was abdominal pain nausea and vomiting. The common site of cholelithiasis was gall bladder (93.75%) and most of the cases were subjected to laparoscopic procedure (90%). We found surgical site infection and biliary leaks as the post-surgical complications.
Conclusion: Prevalence of cholelithiasis is substantially increased due to the changes in life style and eating habits of people considering the associated risk factors, care must be taken inorder to reduce the economic as well as health loss.
Keywords: Cholelithiasis, Laparoscopy, Cholesterol Stone, Calculi.
References
- Johnston DE, Kaplan MM. Pathogenesis and treatment of gallstones. N Engl J Med. 1993;328:412-21.
- Shaffer EA. Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Curr Gastroenterol Rep., 2005;7(2):132-40.
- Portincasa P, Moschetta A, Berardino M, Di-Ciaula A, Vacca M, Baldassarre G et al. Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in beta-thalassemia major adults. World J Gastroenterol 2004;10 (16):2383-90.
- Sharma MA. Towards a safer cholecys-tectomy - The fundus to porta approach. Indian J Surg., 1997;59(4):141-5.
- Vegunta RK, Raso M, Pollock J,Misra S, Wallace LJ, Torres AJ et al. Biliary dyskinesia: the most common indication for cholecystectomy in children. Surgery, 2005;138(4):726-31.
- Angelico M, Gandin C, Canuzzi P, Bertasi S, Cantafora A, De Santis A, et al. Gallstones in cystic fibrosis: a critical reappraisal. Hepatology, 1991;14(5):768-75
- Stringer MD, Taylor DR, Soloway RD. Gallstone composition: are children different? J Pediatr.,2003;142(4):435-40.
- Greenberger NJ, Paumgartner G: Diseases of the gallbladder and bileducts. Harrison’s Principles of Internal Medicine 15th Braunwald E, Fanci AS, Kasper DL, Hanser SL, Longo DL Jameson JL, McGraw - Hill. Pg. 1776-88.
- Bansal A, Akhtar M.A. 2014. clinical study: Prevalence and Management of Cholelithiasis. Int Surg J., 2014; 11(3):134-9.
- Calvin HL Law, Tandan VR. Gallstone disease: surgical treatment. MJ Books. Evidence-based Gastroenterology and Hepatology. McDonald JWD, Burroughs AK, Feagan BG. 1999:260-70.
- Battacharya R. Cholecystectomy in west port, New Zealand. Indian J Surg., 1983:450-5
- Sharma MA. Towards a safer cholecyste-ctomy – The fundus to porta approach. Indian J Surg., 1997;59(4):141-5.
- Thamil SR, Sinha P, Subramaniam PM, Konapur PG, Prabha CV. A clinicopathological study of cholecystitis with special reference to analysis of cholelithiasis. Int J Basic Med Sci., 2011;2(2):68-72.
- Maskey CP, Shrestha ML, Sato Y. Gallstone in TUTH. JIOM. 1990;12:45-54.
- Huang J, Chang CH, Wang JL, Kuo HK, Lin JW, Shau WY, Lee PH. Nationwide epidemiological study of severe gallstone disease in Taiwan.BMC Gastroenterology 2009, 9:63
- Chandran P, Kuchhal NK, Garg P, Pundir CS. An extended chemical analysis of gallstone. Indian J Clin Biochem., 2007; 22(2):145-50.
- Pundir CS, Rani K, Garg P, Chaudhary R, Chandran P, Kumari M. Chemical analysis of biliary calculi in Haryana. Indian J Surg. 2001;63:370-3.
- Mohan H, Punia, RPS, Dhawan, SB, Ahal S, Sekhon MS. Morphological spectrum of gallstone disease in 1100 cholecystec-tomies in North India. Indian J Surg.,2005; 67:140-2
- Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gallbladder carcinoma. Aust N Z J Surg. 2000;70(9):667-73.
- Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS et al. Gallstones and the risk of biliary tract cancer: A population based study in China. Br J Cancer, 2007;97:1577-82.
- Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F. Diet as a risk factor for cholesterol gallstone disease. J Am CollNutr., 2004;23(3):187-96.
- Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecyste-ctomy for acute cholecystitis. Ann Surg., 1998;227(4):461-7.
- Schlumpf EA. Epidemiology of gallbladder stone disease. Best Pract Res ClinGastroenterol.2006;20(6):981-96.
Corresponding Author
Dr Praveen Kumar Garg
Assistant Professor (General Medicine),
Government Bangur Hospital, Pali, Rajasthan, India