The study on clinical profile of patients with gallstones
Dr. Arvind Kumar Singh, Dr. Sahjanand Prasad Singh
Introduction:Cholelithiasis means the “presence of stone in the gall bladder” is a common clinical entity affecting the adult population of both sexes. Various sign and symptoms like severe pain in Murphy’s point in right upper quadrant of abdomen, bilious vomiting, mild to moderate increase in temperature, obstructive jaundice, loss of appetite and weight are present in cholelithiasis. Gallstones are known to produce diverse histopathological changes in the gallbladder. Aims: The study was undertaken to assess prospectively the influence of physical, clinical and biochemical characteristics on type of gallstones and their relationship in patients of cholelithiasis. Materials and Objectives: The study was done in hundred patients of cholelithiasis of both sexes, aged between 12 years to 80 years who underwent cholecystectomy. The stones were assessed for various parameters i.e. number, size, morphological types and correlated with clinical Indices of cases (Hemoglobin, TLC, DLC, Blood sugar, SGOT, SGPT, Alkaline phosphatase, total serum bilirubin, direct serum bilirubin, Indirect serum bilirubin, total serum protein and albumin values ) and also with diabetes mellitus, smoking, tobacco chewing, alcohol intake and dietary habits of cases of cholelithiasis. Results: Out of total 100 specimens examined in present study, 24 had cholesterol (male -4, female- 20), 46 had mixed (male-11, female- 35) and 30 had pigmented (male- 11, female-19) gallstones respectively. Number of stones varies from a single calculus in 30% cases, double in 12% cases and multiple in remaining 58% cases. Shape of stone varied from polygonal/rectangular in 1% cases, ovoid in 15%, rounded in 22%, irregular in 29% and maximum had faceted shaped gallstone in 32% of cases. Haemoglobin, TLC, DLC, Blood sugar, SGOT, SGPT, Alkaline phosphatase, total serum bilirubin, direct serum bilirubin, Indirect serum bilirubin, total serum protein and albumin values did not showed statistically significant correlation with gallstone types. Conclusion: Mixed gallstones more common among females and association of biochemical indices needs further exploration. Therefore gender, ethnicity and other clinical features can be used as the factor to predict the formation of gallstones disease. It is also recommended that all patients should go through the analysis of all the biochemical parameters before cholecystectomy.