Clinicopathological study and management of biliary stones

Abstract

Background: Biliary calculi are one of the most common problems affecting the digestive tract. Need for the study is to evaluate age, sex, incidence, most common etiopathological factors for the formation of biliary calculi and to illustrate varying clinical presentation with various modes of management adopted in the institution as well as to analyse biochemical types of stones prevalent in the region.Methods: A prospective study of 50 patients with clinical diagnosis of biliary colic was conducted in a tertiary center for a period of one year. Clinical presentation, etiology, and management of biliary calculi were studied.Results: Biliary calculi affect most commonly in fourth to the fifth decade with a higher preponderance in females (72%). Right hypochondriac pain is the commonest presentation (84%). Ultrasonography is sensitive and specific, and hence considered the investigation of choice. Open surgical procedures such as cholecystectomy, choledochotomy with T-tube drainage, choledochoduodenostomy were done in these subjects. Postoperative complications such as wound infection noted in 8% of the subjects. Most of the histopathological specimens (90%) revealed chronic cholecystitis.Conclusions: Biliary calculus disease is multifactorial in origin with slight female preponderance. The most common presentation is a right hypochondriac pain. This can be diagnosed accurately with the aid of ultrasonography and Endoscopic Retrograde Cholangio-pancreatography. Biliary calculus is managed according to the location of the calculus, whether intrahepatic or extrahepatic. Most of the patients presented with chronic cholecystitis.