Gallstone disease menacing rural population in north India: a retrospective study of 576 cases in a rural hospital

Abstract

Background: Cholelithiasis is a commonly encountered entity by surgeons all over the globe. Its significantly higher incidence in certain regions of world like north India is a matter of concern. Patients with recurrent symptoms of gallstones are having higher rates (1-2%/year) of complications. Methods: It is a retrospective study of 576 cases of gallstones managed in our rural institute. The aim of present study is to highlight the current status of gallstone disease and its complications in a rural population in North India. Results: Females were predominantly involved with a female/male ratio of 3.3:1. Majority of the cases (66.14%) belonged to young (20-50 years) age group. About 65 % of the cases presented with complicated gallstones revealing extent of burden faced by our patients. Serious complications like gallbladder perforation, pancreatitis and gallbladder carcinoma were also reported in a significantly higher percentage (approx. 13%) of the study group alarming the native population. More than half of the cases (58%) were managed by laparoscopic method without significant conversion rates (2.08%). Postoperative complications were detected in about 10% of the cases; all of them were managed conservatively except single case of bile duct injury needing hepaticojejunostomy. There was paucity of data related to complications of gallstone disease in Indian population making it a worth and unique attempt. Conclusions: Early detection and management of symptomatic gallstones is the key to prevent gallstones related complications.