Correlation of Gallstone Characteristics with the Clinical Parameters in Cases of Cholelithiasis
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 i...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2015-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2046/1-%2013696_F(AK)_PF1(VSUAK)_PFA(AK)_PF2(VSUAK)_OLF.pdf |
| Summary: | 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 gall
bladder.
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 Methods: 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 (Haemoglobin, 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 (male11, female-19) gallstones respectively. Number of stones
varies from a single calculus in 30% cases, double in 12%
cases and multiple in remaining 58% of 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. The mean systolic BP (p<0.27) and
the mean diastolic BP (p<0.012) in patients having cholesterol, mixed and pigmented gallstones showed statistically
significant association 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. |
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| ISSN: | 2277-8543 2455-6874 |