A CLINICAL STUDY ON CHEMICAL ANALYSIS OF GALLS STONES AND SURGICAL MODALITIES

Dr. Sameer Babu Umeer, Dr. Thota Siddhartha, Dr. Anand Shankar. S

Abstract


BACKGROUND: There has been a marked increase in the incidence of the gall stone in India due to westernization and availability of
investigations. The patho physiological interest lies in the composition of gall stones. Analysis of chemical composition of gallstones can provide a
significant reference to the treatment and prevention of their reoccurrence.
AIM AND OBJECTIVES OF THE STUDY: To study the chemical composition of gall stones, their presentations and various surgical
modalities for cholelithiasis in AVMC&H, Pondicherry.
MATERIALS AND METHODS: Around 50 consecutive patients, diagnosed as a case of cholelithiasis, which were all examined, investigated
and operated, were enrolled in the study during the period of 2 years. Those patients who were managed conservatively were excluded from the
study. After detailed history taking and routine investigations patient were planned for emergency or elective operative procedures. Based on
operative criteria either open or laparoscopic cholecystectomy was done. Gall stones retrieved was studied for its composition such as cholesterol,
bilirubin, inorganic phosphate and calcium by various biochemical analyses. Type of stone and their correlation were analyzed by statistically.
RESULTS: The highest age incidence of cholelithiasis was in the 5th and 6th decade with maximum incidence in the 5th decade. There was an
increased incidence in female. Pain was the most common symptom(present in 98% of the patients), nausea and vomiting were the second most
common symptom presenting in 56% of patients, dyspepsia was present in 24% of patients, jaundice in 14% of the patients, 8% of patients had
fever. Tenderness in the right hypochondrium was the most common sign present in 96%, guarding was the next sign present in 30% of the patients
and mass abdomen in 8% of the patients. 48% of patients undergone laparoscopy cholecystectomy, 52% of patients undergone open
cholecystectomy. Lap to open conversion rate was 4% in our study. Gallstones analysis showed mixed stone in 90% of the cases and cholesterol
stones in 8% of the cases as the most common variety.
CONCLUSION: The gall stones were common in females and the most common presentation was pain over upper quadrants of abdomen.
Commonly employed surgery for cholelithiais was open cholecystectomy and most commonly mixed type of gall stones was retrieved.


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