Vol. 9, Issue 1, Part D (2025)
Clinical presentation and surgical management of cholelithiasis along with chemical analysis of gallstones
Dr. Zulekha Bhimani, Dr. AK Gvalani, Dr. Jayant Pednekar, Dr. PS Eswar, Dr. Nidhi Shah and Dr. Mehnish Malik
Introduction: Cholelithiasis represents one of the most prevalent gastrointestinal disorders worldwide, affecting 10-15% of adults. Understanding its clinical presentation, management outcomes, and stone composition is crucial for optimal patient care.
Methods: A prospective cross-sectional study was conducted on 100 patients with cholelithiasis who underwent cholecystectomy between 2021-2022. The study evaluated demographic profiles, clinical presentations, surgical outcomes, and chemical composition of gallstones.
Results: The mean age of patients was 43.26 ± 11.26 years, with female predominance (68%). Most patients presented with symptomatic disease (70%), with pain and dyspepsia being the primary symptoms. Laparoscopic cholecystectomy was successfully performed in 79% cases, with a 16% conversion rate to open surgery. Main reasons for conversion included bleeding (4%), CBD injury (1.2%), and fibrosis of Calot's triangle (6%). Chemical analysis revealed mixed stones as the most prevalent (82%), followed by pigmented (12%) and cholesterol stones (6%). A notable age-related correlation was observed in stone composition, with cholesterol stones appearing exclusively in patients above 40 years.
Conclusion: The study demonstrates that while laparoscopic cholecystectomy remains the gold standard treatment, proper patient selection is crucial. The predominance of mixed stones across all age groups and the age-related distribution of cholesterol stones suggest metabolic factors influencing stone composition.
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