Changing trends in the epidemiology and presentation of gall stone disease in Bundelkhand region of Northern India

Abstract

Background: Gallstone disease is fairly prevalent and expensive ailment, demanding approximately 700,000 cholecystectomies annually. Its complications expenses are over $6.5 billion in the United States. In developed countries, at least 10% of white population harbor cholesterol gallstones; women have twice the risk, and increasing age increases the prevalence in both sexes. Objectives: To evaluate the epidemiology and demographics of gall stone disease in Bundelkhand region and comparative analysis of changing trends with respect to its presenting population. Methods: This comparative study was conducted in a tertiary care centre teaching hospital between September 2012 to September 2014. 150 consecutive patients who fit into the inclusion criteria were included in the study. Random allocation of patients presenting with symptoms suggestive of gall bladder disease with confirmatory USG study was done and patients are allocated into 2 arms. ARM 1- CC with CL (Chronic cholecystitis with cholelithiasis) ARM 2-Others-Mucocele, Empyema GB, Acute cholecystitis with cholelithiasis(AC with CL), Xanthogranlumatous cholecystitis. The details of all are recorded in a proforma (Annexure). Statistical analysis was carried out and all the observations and results were evaluated to arrive at a conclusion. Results: Majority of presenting patients were in age group 30-40 years(33%). Youngest patient included in the study is 14yrs, oldest being 85yrs. 25% of the operated patients were males and 75% females and there was no significant difference among the two groups. Interpretation & Conclusion: Age group presenting with cholelithiasis to our centre is significantly younger(30-40yrs) than age group documented in other studies(40-50yrs). As documented by other studies majority of patients present with chronic cholecystitis with cholelithiasis(90%). Other presenting pathologies are mucocele of gall bladder(5%), empyema(2%), acute cholecystitis with cholelithiasis(2%), xantogranulomato