Online ISSN: 2515-8260

Keywords : Gallstones


A RETROSPECTIVE HISTOLOGICAL STUDY OF GALLBLADDER DISEASE

Aashish Gupta, Amod Kumar, Payal Kumari, Monica

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2510-2514

Background: Gallbladder disease is known to affect a substantial number of people throughout the world. In India, the disease prevalence is on the rise, largely attributable to dietary & lifestyle changes, thus causing a significant disease burden. The purpose of this study is to evaluate the varied histological manifestations of gallbladder pathology and their association with cholelithiasis.
Materials & methods: This retrospective study was conducted in a tertiary medical centre in Patna from January 2020 to December 2020. The clinical data and the histopathological changes were evaluated.
Results: Of the 156 cases which were studied, 120 cases (77%) had gallstones. The mean age was 47 years. Females had a slight preponderance for gallbladder diseases with the Male: Female ratio being 1:2. 138 cases (88.5%) were diagnosed as chronic cholecystitis. 1.92% cases were diagnosed to have invasive malignancies.
Conclusion: A diverse spectrum of diseases affect the gallbladder encompassing inflammatory conditions, parasitic infections, pseudoneoplastic lesions and neoplasms. Routine cholecystectomy specimens should be evaluated meticulously as incidental findingss and diagnosis can be transformative.

Study of preoperative factors as predictors in failed laparoscopic cholecystectomy requiring conversion to open cholecystectomy at a tertiary hospital

Kumble Ananth Prabhu, Yateesh H M, Basil Ibrahim, Ajmal. A

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1257-1262

Background: Laparoscopic cholecystectomy is considered the treatment of choice for symptomatic Cholelithiasis. However, of all Laparoscopic cholecystectomies, 1-13% requires conversion to an open for various reasons. Present study was aimed to Study various preoperative factors as predictors of laparoscopic cholecystectomies required conversion to  open route at our tertiary hospital.
Material And Methods: Present study was case record based, retrospective study, conducted among case records of patients who required conversion to open cholecystectomy from laparoscopic cholecystectomy was done.
Results: In present study, among 530 laparoscopic cholecystectomy (LC) procedures, 42 cases required conversion to open cholecystectomy (OC) and conversion rate was 7.92 %. In cases required conversion, indication for cholecystectomy were recent acute cholecystitis (40.48 %), recent obstructive jaundice (21.43%) and impacted stone (16.67 %). In cases required conversion, common intraoperative events observed were significant bleeding (47.62%), fibrosis (35.71%), dense adhesions at calot’s triangle (30.95%) and difficult port entry (26.19%). On analysis of preoperative risk factors age >50 years, Male gender, previous history of hospitalisation due to acute cholecystitis, Palpable gallbladder, BMI > 30 kg/m2, history of previous laparotomy, USG findings of thick-walled GB (>4mm), and Pericholecystic collection were related to failed laparoscopic cholecystectomy surgery required conversion to open procedure.
Conclusion: Age >50 years, Male sex, previous history of hospitalisation due to acute cholecystitis, Palpable gallbladder, BMI > 30 kg/m2, history of previous laparotomy, USG findings of thick-walled GB (>4mm), and Pericholecystic collection were found to be significant pre-operative predictive factors in laparoscopic cholecystectomies required conversion to abdominal route.

Clinical profile of patients treated with cholecystectomy at a tertiary care hospital

Dr.SadiqHusainKachavi, Dr.CG Sunil, Dr.Sandeep Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 428-432

Gallstones are composed predominantly of cholesterol, bilirubin and calcium salts with lesser amounts of other constituents. The most popular classification system uses the relative amount of cholesterol as the main criterion and designates gallstones as being either cholesterol or non-cholesterol. The latter are further classified as black or brown pigment stones. A thorough preoperative anaesthetic evaluation was done and patient fitness for general anaesthesia assessed. A dose of antibiotics (usually a cephalosporin) was given 30 minutes before surgery. A nasogastric tube was inserted routinely. The most common indication for open cholecystectomy was symptomatic cholelithiasis (68%). In the laparoscopic group also cholelithiasis (76%) was the most common cause.

Descriptive study on the clinical profile of patients with cholelithiasis

Dr. M Gururaj, Dr. J Mayur Kumar,Dr.M Lakshman Kumar Yadav, Dr.BalaMurali Krishna Mudiyam MS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1245-1249

In India, the incidence of the disease is on the increase due to the change in diet patterns and
the greater awareness of the problems. A gallstones survey limited to railroad workers
conducted in 1966 utilizing oral cholecystography had suggested that gallbladder stones
occurred 7 times more commonly in North Indian workers than in South Indian workers.
Patients were selected according to inclusion and exclusion criteria after taking informed
consent and reassuring them keeping confidentiality of their data. In all the 200 patients,
patients diagnosed as cholelithiasis and who underwent laparoscopiccholecystectomyor
converted to open-cholecystectomywere included in the study. After explaining complete
details of the procedure and complications to the patients, the surgery was performed under
general anesthesia. In our study out of 200 patients, majority of patients, both male and
female had pain as their chief complaints with total percentage of (62%).Next to pain
majority of patients including males (10) and females (16) Nausea as major complaint
constituting (13%) of total average. Dyspepsia 21 i.e., (10.50%), pain + nausea 15 i.e.,
(7.50%) and pain + jaundice 14(7%) as their chief complaints in decreasing order.

Open cholecystectomy versus laparoscopic cholecystectomy: A comparative study at north Indian based teaching hospital

Dr. Vipin Kumar, Dr. E.D. Reddy, Dr. Chandra Shekhar, Dr. Madhu Sinha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 586-591

Background: Gallstone disease (GSD or Cholelithiasis) is a significant health problem
both worlds over (in both developing and developed nations). The main objective is
Laparoscopic cholecystectomy has rapidly become established as the popular alternative to
open cholecystectomy, but it should have a safety profile better than of open procedure.
Aims and objectives: The aim of this study was to compare conventional cholecystectomy
and laparoscopic cholecystectomy with respect to duration of procedure, complications,
postoperative pain, analgesic requirement and period of hospital stay.
Materials and Methods: This study consists of 52 patients who have undergone gallbladder
removal in GMC Budaun. 26 patients who have undergone laparoscopic cholecystectomy
and 26 patients who have undergone open cholecystectomy for a study period of one year
have been taken into the study In method 52 consecutive patients below 70 years presenting
with calculous cholecystitis with no evidence of CBD stones were randomized to undergo
open and laparoscopic cholecystectomy.
Results: 9 patients of LC and 10 patients of OC were males. Among LC 16 patients were
females and among OC group 15 were females, 28% of patients who underwent open
surgery had complications and 16% of patients who underwent laparoscopic surgery had
complications. The overall percentage of complications is lesser in laparoscopic surgery
than open surgery, The VAS was median grade 2 in LC group as compared to median
grade 4 in LC group. The NSAID’S were used for more days in OC group compared to LC
group, 23 patients who underwent laparoscopic cholecystectomy were discharged before 5
days. All patients who underwent OC stayed >5 days in hospital.
Conclusion: Herewe conclude in results, the duration of pain, rate of complications and
hospital stay were significantly lower in laparoscopic group. However the main advantages
of LC were reduced postoperative pain with less duration of analgesic intake, more rapid
recovery, reduced hospital stay and early return to normal work.