A clinicopathological study and management of cholelithiasis

Background: Gallstones are one of the commonest medical problems leading to surgical intervention. There is recent rise in the incidence of cases due to westernization of diet. This study intends to know the various modes of presentation, its complications and various treatment modalities with their outcomes. The aim of the study is to study the prevalence of cholelithiasis and to evaluate the advantages and disadvantages of laparoscopic versus open cholecystectomy surgical procedures. Material and methods: This was a prospective study conducted at tertiary care centre for a period of two years. 100 consecutive cases of cholelithiasis were admitted, investigated and operated during this period and results analysed. Results: Cholelithiasis was common in the 4th decade with majority of cases occurring in females. The commonest clinical presentation was pain abdomen. All the cases were diagnosed on ultrasonography abdomen. The diet consumed was mixed diet. Laparoscopic cholecystectomy was done in 72 cases and 28 cases underwent open cholecystectomy. The conversion rate was 4%. The complications were minimal. Mean operating time for open cholecystectomy was 96 minutes and laparoscopic cholecystectomy was 90 minutes. Mean duration of hospital stay was 9 days for open cholecystectomy and 4 days for laparoscopic cholecystectomy. Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment in most of the patients with symptomatic cholelithiasis. In cases of adhesions and inflammation, open cholecystectomy is preferred.