Clinicopathological study of gall bladder disorders

Abstract

Background: The people of new world are highly susceptible to gall bladder disorder, which include cholelithiasis and its complication and malignancies. Gall bladder and rest of biliary system diseases are known from ancient time. The ladder of development of treatment has shifted from conservative attitude to the most modern intervention by endoscopy and laparoscopy. This study aims to look at the demographics, operative morbidity and pathology of the removed gallbladder in the local population. Methods: This is a prospective study in which 350 patients presenting with definitive diagnosis of gallbladder disorders or presenting with clinical features suggestive of cholecystitis and later on diagnosed as acute cholecystitis or other gallbladder disorders, were included in the study. Their demographic data, symptomatology and associated illness were documented. In acute condition we followed conservative line of treatment and who are not responding to conservative measure or who were admitted for routine surgery we followed operative measure either laparoscopic or open cholecystectomy, the gallbladder specimen was sent for histopathological examination and bile was sent for bacteriological examination. Results: The incidence of the gallbladder disorders was 4.23% of the total admission and maximum number of patients recorded in the month of October. The ratio of male: female was 1:4.3 and most of the female were multipara. Maximum number of patients recorded in the age group of 31- 40 year. Maximum number of patients belongs to middle socioeconomic group and consumed mixed diet. Majority of patients present with pain in abdomen. 69.43% patients treated conservatively rest were treated by open or laparoscopic cholecystectomy. 24.30% patients had positive culture for bacteriological examination and most commonly isolated organism was E.Coli. All the patients had chronic cholecystitis on histopathological examination. Conclusions: The result showed most common disorder of gallbladder was acute calculous cholecystitis and gallbladder disorders were more common in multiparous females of 4 th decade. Most of the patients presented with pain in right hypochondrium. All the patients with acute condition were responded to conservative management. In operative intervention laparoscopic cholecystectomy is much better than open cholecystectomy because of reduced hospital stay with lesser post-operative morbidity.