Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
A prospective observational study of 30 cases of gall stones admitted in the Department of General Surgery was conducted. The incidence was more in 5th decade of life in the present study followed by 6th and 4rd decades. The incidence is more in females when compared to males. Out of 30 cases, 21 (70%) are females and 9 (30%) are males. The sex ratio of female to male is 2.33:1. Most of the patients in our study presented with pain as the most common symptom which accounts for 97%. The other symptoms with which patients presented to the hospital are dyspepsia (40%), vomiting (10%). 3% of cases presented with fever and 3% of cases presented with jaundice. In these cases, right hypochondrium and epigastric tenderness was the most common clinical sign elicited in 97% of the cases. Guarding was elicited in 20% of the cases. Icterus and mass were noted in 3% of the cases. USG is used as the investigation of choice in the current study. The imaging results show 100% of cases with gall stones. Among them, 70% has multiple stones and in this group, 3% had both gall stones and CBD stones. Solitary stones were noted in 30% of the cases. Various complications that are associated with cholelithiasis in the current study are chronic cholecystitis in 80% of the cases and acute cholecystitis in 13% of the cases. 3% had acute pancreatitis secondary to choledocholithiasis and 3% are presented with perforated gall bladder and empyema gall bladder. As a part of management, 50% of the cases underwent laparoscopic cholecystectomy and 50% of the cases underwent open cholecystectomy. No cases in this study who underwent laparoscopic cholecystectomy were converted to open cholecystectomy. The complications noted with laparoscopic cholecystectomy are intraoperative stone spillage in one case (6.6%). In case of open cholecystectomy, intraoperative and postoperative bile leak was noted in 6.6% of cases and wound infection was noted in one case (6.6%). Postoperative bile leak was managed conservatively and wound infection was managed with drainage of pus and appropriate antibiotic administration. Chronic cholecystitis is the most common histopathological report of gall bladder followed by acute cholecystitis. Most common type of stones were mixed stones (67%) followed by cholesterol stones (30%) and pigmented stones (3%).There was no significant difference in the duration of operative procedure in both open and laparoscopic cholecystectomy groups. The average duration for laparoscopic cholecystectomy was 90min and for open cholecystectomy, it is 90min.In laparoscopic cholecystectomy group, the mean duration of hospital stay is 4 days in most of the cases and time taken for them to return the normal work is 7 days. In case of open cholecystectomy group, the mean duration of hospital stay is 8 days and time taken for the cases to return to their normal activity is 11 days. Both the results in open cholecystectomy group were considerably higher when compared to laparoscopic cholecystectomy group.
How to cite this article:
B. Chandra Sekhar Reddy and D. Vijaya Kumar. A Study on Clinical Presentation Management and Outcome of Cholelithiasis.
DOI: https://doi.org/10.36478/10.36478/makrjms.2023.12.602.606
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2023.12.602.606