Analysis of gallstones disease correlating with clinical symptoms in patients with calculous cholecystitis in emergency surgical unit at Kilpauk Medical College

Background: Gallstones, complex biomineralized deposits formed in the gallbladder, are still a major health problem all over the world. Cholelithiasis is common with the incidence ranging from 10% to 20% of the world population. Over the past two decades, a great deal has been learned about the epidemiology of and risk factors for gallstones. Ultrasonography has played a major role in this process, providing a rapid, risk-free method of screening large populations. Prior to the availability of ultrasound, most studies relied on highly selective autopsy data and limited oral cholecystography. Aim and objectives: To determine the Biochemical analysis of Gall stones and to study the clinical spectrum of acute cholecystitis. Materials and methods: About 50 consecutive cases were admitted, examined, investigated and diagnosed as calculus cholecystitis during the period of January 2016 to September 2016 are selected and detailed history of all the 50 cases were taken according to the proforma. Information regarding the age, nature of the symptoms, and duration of the symptoms, diet history, and history of OCP intake, Alcohol ingestion, and diabetes were obtained. All patients' undergone detailed examination underwent investigations. Results: All cases fall between 22 and 75 years. There is an increased incidence in the 5th and 6th decade with the maximum incidence in the 5th decade. Pain abdomen was the most common presenting symptom in our study seen in 49 (98%) of the cases followed by fever in 17 (34%) cases. Dyspepsia was seen in 12 (24%) cases, 7 cases (14%) each presented with nausea/vomiting or jaundice. Among the ultrasonographic findings of cholelithiasis most common finding was thickened gall bladder wall seen in 40 cases (80%) Ultra sonogram revealed 76% (38 cases) had multiple stones and 24% (12) has solitary stone. Mass was seen in 5 cases (10%).Of the total 50 cases with cholelithiasis 38 patients (76%) had mixed stones, followed by pigment stones in 8 cases (16%) followed by cholesterol stones in remaining 4 cases (8%). Majority of the patients were in the age group 41-50 (32%) followed by the 51-60 age group (24%). Conclusion: Majority of patients underwent Laparoscopic cholecystectomy (86%) with reduced number of stay in the hospital, pain and disability as compared to open cholecystectomy. The commonest type of stone was mixed stone. Most of the gallstones were associated with grade 1 cholecystitis (78%), Grade 2 cholecystitis was seen in 20% of our study patients, Grade 3 was seen in 2% of our study patients.