Abstract

CHOLEDOCHOLITHISIS: A CLINICAL STUDY WITH ITS MANAGEMENT

Abhijit Sarma, Purujit Choudhury* and Subhanka Sharma

ABSTRACT

Background: Gallstone diseases are one of the most common biliary pathology. Prevalence of gallstone is 10-14% in adult population of eastern world. About 3-14.7% of cholelithiasis may be associated with common bile duct stones. The aim of this study is to study the clinical spectrum of choledocholithiasis and to study the various surgical methods available of the disease. This study also aims primarily to compare t tube closure of CBD with primary closure of CBD in terms of complication and hospital stay. Materials and Methods: This is a prospective study carried out in the department of surgery of Guwahati medical college. This study includes 110 patients who underwent various types of surgeries for choledochotomy. Stones in the CBD were detected on the basis of preoperative USG and MRCP. Results: The mean age of patients was 46.37±10.7 years and pain was the most common presenting symptom. Pain abdomen was present in 72 patients at the time of diagnosis. Jaundice was present in 42 patients where as fever was present in 30 patients. Open choledochotomy with t tube closure was done in majority of patients. Out of 110 patients 17 patients had developed various complications. Mean hospital stay of patients underwent surgery for choledochotomy is found to be 8.69 days. Mean hospital stay in primary closure is 5.86 days as compare to 10.16 days in t tube closure Conclusions: MRCP is more sensitive than USG and there is no significant difference between primary closure and T tube closure in terms of complication but primary closure is way better than t tube closure in terms of hospital stay.

Keywords: Gallstone diseases, Choledocholithiasis, Gallstone, Surgical management, Choledochotomy.