A study on calculous cholecystitis in Government Rajaji Hospital, Madurai

Sudha, P (2010) A study on calculous cholecystitis in Government Rajaji Hospital, Madurai. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Gall stones are among the most common gastro intestinal illness requiring hospitalization and frequently occur in young, otherwise healthy people. Most patient remains asymptomatic from their gallstones. Although the mechanism is unclear, some patients develop symptomatic gall stones with biliary colic caused by a stone obstructing the cystic duct. In my study, I have analysed the prevalence and incidence of calculous cholecystitis diseases. Age incidence, clinical features and investigatory procedure and types of management for gall stone disease. AIM OF THE STUDY: This study comprises of 82 consecutive cases of cholecystitis admitted and treated in Madurai Medical College. The aim of the study is to analyze the following: 1. The incidence and prevalence of calculous cholecystitis disease in and around this region as represented in Madurai Medical College. 2. To study the age and sex incidence. 3. To study the clinical features and investigatory procedures that help in diagnosis. 4. To compare and evaluate the management of gall stone disease. 5. To study the nature of procedure and their outcome. 6. To evaluate the post operative complication and their outcome. MATERIALS AND METHODS: The study material consist of 82 cases of Cholecystitis in all the seven surgical units of our department of Madurai Medical College Hospital, Madurai during the period from December 2007 to October 2009. All cases of pain abdomen admitted in the surgical ward were carefully and thoroughly examined to arrive at a clinical diagnosis. A preformed proforma was carefully filled up giving particular importance to the duration of illness, general and special investigations, and wherever possible, histopathological examination of the specimen was carried out. The following procedures were adopted according to the condition of the patient, ie. 1. Conservative management, 2. Open cholecystectomy, 3. Open cholecystectomy with T-tube drainage, 4. Laparoscopic cholecystectomy. If selected cases, preoperative, peroperative and post operative clinical and operative photographs were taken. All the patients were followed up in the immediate post operative period and in the subsequent period ranging from 3 months till the end of the study period. SUMMARY: In my study of 82 patients increased incidence of age for gall stone disease was between 41-50 years and females was found to have gall stone disease than males and almost most of the patient have right hypochondrial pain and tenderness and only 6 patients have been incidently diagnosed to have gall stones and they were preceeded with cholecystectomy with incisional hernia. Out of 82 patients 72 patients have only gall stones and 11 patients have associated CBD stones and those patients was proceeded with cholecystectomy with CBD exploration. 59 patients was treated with open cholecystectomy and 23 patients with lap cholecystectomy. Outcome of overall prevalence of gall stone disease is correlated with prevalence in South India and United States. CONCLUSION: 1. The overall incidence of cholecystitis was 9% out of all admission in my study period. 2. The age incidence varies between 21-80 years with a peak incidence in the age group of 41-50 years. 3. Female preponderance of 2 : 1 was observed in my study. While the Indian studies showed a more incidence in males the western showed a more male preponderance. 4. Mixed stones are the most common type of gall stone. 5. Common presenting symptom was right hypochondrial pain. The commonest sign was Right hypochondrial tenderness. 6. Ultrasonogram was the investigation of choice because of its simplicity, safety, repeatability and accuracy, it was used in all the cases in my study. 7. Elective open cholecystectomy was the widely followed method of surgical treatment. 8. The increasing trend towards laproscopic cholecystectomy was obvious in my study. The trend was due to shorter hospital stay, lesser post operative pain and faster recovery.

Item Type: Thesis (Masters)
Uncontrolled Keywords: calculous cholecystitis ; Government Rajaji Hospital ; Madurai.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 02 Jun 2018 15:13
Last Modified: 02 Jun 2018 15:55
URI: http://repository-tnmgrmu.ac.in/id/eprint/8096

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