The Effect of Gallstone Presentation on Treatment Outcome in Symptomatic Cholelithiasis
Introduction: Gall stone disease (GSD) is a common surgical problem. Surgical treatment of asymptomatic GSD is still controversial. Complicated GSD has varied presentation and contributes substantially to healthcare costs and may be life threatening. The present study is aimed to know the effect of gall stone presentation on treatment outcome.
Methodology: This is a retrospective study conducted in a tertiary health care centre. All patients who underwent cholecystectomy (open or laparoscopic) were included in the study and were grouped in uncomplicated (Group A) and complicated group (Group B), depending upon their presentation. Treatment outcome was analysed for various measures i.e. type of admission (emergency or elective), length of hospital stay, postoperative complications, type of surgery and mortality.
Observations: Out of the 202 patients, 109 (53.9%) were in group A and 93 (46.1%) were in group B. Acute cholecystitis comprised 30.1% of complicated GSD, whereas gall stone pancreatitis, choledocholithiasis, mucocele, empyema gall bladder, perforation and gall stone ileus comprised 6.9%, 2.9%, 3.9%, 0.9%, 0.4% and 0.4% respectively. Comparatively, patients with uncomplicated GSD were admitted electively, were mostly managed laparoscopically and had lower incidence of post-operative complications and hence shorter length of hospital stay and lower treatment cost.
Conclusion: Most of the patients who present early in course of GSD have better treatment outcome. We recommend early elective laparoscopic surgery for all patients who present with initial symptoms of GSD.
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