MANAGEMENT OF SYMPTOMATIC GALL STONES IN A TERTIARY CARE HEALTH FACILITY IN SOUTHERN NIGERIA

Main Article Content

PROMISE N. WICHENDU
A. DODIYI-MANUEL
KELECHI IKONWA

Abstract

Background: Gall stone disease is one of the most common problems affecting the digestive tract. The disease spectrum ranges from silent stones to symptomatic stones with its various complications. The disease is relatively uncommon among people of the black race being unknown amongst the Bantu and Masai tribes of Africa. The main stay of treatment is surgery. Open surgery was once the only option surgically but with the advent of minimally invasive techniques laparoscopic cholecystectomy has now become the gold standard of surgical care.

Aim: Although not common in this environment there is a need to evaluate the age and sex prevalence, types of stone prevalent here, varying modes of clinical presentation and spectrum of the disease as well as treatment modalities adopted in this institution.

Methods: This is a retrospective review of all cases done in this institution within a sixteen-year period. The case files of these patients were retrieved and relevant information extracted using a proforma. The results were analysed using SPSS VERSION 22.

Results: The collated information showed that gall stone disease is commoner in females with a male female ratio of 1: 5.6 the most preponderant age group was 41-50 years, commonest mode of presentation was recurrent right hypochondrial/epigastric pain. Commonest stone type was mixed contrary to what obtains in Europe and North America.

Conclusion: This study established that gall stone disease is overwhelmingly preponderant in females in this locality and continue to be treated here by open surgery.

Keywords:
Cholecystectomy, open, laparoscopic, gall stone, disease

Article Details

How to Cite
WICHENDU, P. N., DODIYI-MANUEL, A., & IKONWA, K. (2020). MANAGEMENT OF SYMPTOMATIC GALL STONES IN A TERTIARY CARE HEALTH FACILITY IN SOUTHERN NIGERIA. Journal of International Research in Medical and Pharmaceutical Sciences, 14(3), 98–103. Retrieved from http://www.ikpresse.com/index.php/JIRMEPS/article/view/4916
Section
Original Research Article

References

Thudichum JLW. A treatise on gallstones: Their chemistry, pathology and treatment. London: John Churchill and Sons; 1983.

Shehadi WH. The biliary system through the ages. Int Surg. 1979;64:63–78.

Kratzer W, Mason RA, Kachele V. Prevalence of gallstones in sonographic surveys worldwide. JCU. 1999;27(1):1-7.

Unisa S, Jagannath P, Dhir V, Khandelwal C, Sarangi L, Roy TK. Population-based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic basin of North India. HPB. Official J Inter Hepato Pancreato Biliary Association. 2011;13(2):117-25.

Zubler J, Markowski G, Yale S, et al. Natural history of asymptomatic gallstones in family practice office practices. Arch Fam Med. 1998;7(3):230-3.

Zeng Q, He Y, Qiang DC, et al. Prevalence and epidemiological pattern of gallstones in urban residents in China. Eur J Gastroenterol Hepatol. 2012;24(12):1459-60.

Friedrich N, Volzke H, Hampe J, et al. Known risk factors do not explain disparities in gallstone prevalence between Denmark and Northeast Germany. Am J Gastroenterol. 2009;104(1):89-95.

Grimaldi CH, Nelson RG, Pettitt DJ, et al. Increased mortality with gallstone disease: results of a 20-year population-based survey in Pima Indians. Ann Intern Med. 1993;118(3):185-90.

Barbara L, Sama C, Morselli Labate AM, et al. A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology. 1987;7(5):913-7.

Khuroo MS, Mahajan R, Zargar SA, et al. Prevalence of biliary tract disease in India: A sonographic study in adult population in Kashmir. Gut. 1989;30(2):201-5.

Rahman GA. Cholelithiasis and cholecystitis: Changing prevalence in an African community. J Natl Med Assoc. 2005;97(11):1534-8.

Baskaran V. Prevalence of cholelithiasis in the general population at Chandigarh in northern India. J Gastroenterol Hepatol. 2002;17(12): 1343-4.

Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett PM. Symptomatic and silent gall stones in the community. Gut. 1991;32(3):316-20.

Friedman GD, Raviola CA, Fireman B. Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization; 2018.

Schiff M. Il coleinato di soda nella cura dei calcoli biliari. L’Imparziale. 1873;13:97–98.

Dabney WC. The use of choleate of soda to prevent the formation of gallstones. Am J Med Sci. 1876;71: 410.

Rewbridge AG. The disappearance of gallstone shadows following the prolonged admnistration of bile acids. Surgery. 1937;1:395–400.

Danzinger RG, Hofmann AF, Schoenfi eld LJ. Dissolution of cholesterol gallstones by chenodeoxycholic acid. N Engl J Med. 1972;286:1–8.

Sauerbruch T, Delius M, Paumgartner G, et al. Fragmentation of gallstones by extracorporeal shock waves. N Engl J Med. 1986;314:818–22.

National Institutes of Health Consensus Development Conference Statement on gallstones and laparoscopic cholecystectomy. Am J Surg. 1993;165:390–98.

Joel J. Roslyn, Gregory S. Binns, Edward FX. Hughes, kimberly saunders- kirkwood, Michael J. Zinner, Joe A. Cates: Open Cholecystectomy A Contemporary Analysis of 42,474 Patients, Annals of Surgery. 1993;218(2):129-137.

Lopis S. The incidence cholelithiasis in the Bantu.Clin Proc. 1947;6(8):338-47.

Biss K, Ho KJ, Mikkelson B, Lewis L, Taylor CB. Some unique biologic characteristics of the Masai of East Africa. N Engl J Med. 1971;284:694-9.

Gary D. Friedman, William B. Kannel, Thomas R. Dawber. The epidemiology of gallbladder disease: Observations in the Framingham study. J Chronic Dis. 1966;19(3):273-92.

Ganey JB, Johnson PA Jr, Prillaman PE, McSwain GR. Cholecystectomy: Clinical experience with a large series. Am J Surg. 1986;352-7.

Moreaux J. Prospective study of open cholecystectomy for calculus biliary disease. Br J Surg. 1994;81: 116-9.

Raza MH, Khan MA, Naim M. Gallstone disease, Ind J Surg. 1990;415-20.

Pixley F, Wilson D, McPherson K, Mann J. Effect of vegetarianism on development of gall stones in women. Br Med J (Clin Res Ed) 1985;291:11 2.

Kameda H, Ishihara F, Shibata K, Tsukie E. Clinical and nutritional study on gallstone disease in Japan. Jpn J Med. 1984;23: 109 13.

Moerman CJ, Smeets FW, Kromhout D. Dietary risk factors for clinically diagnosed gallstones in middle aged men. A 25 year follow up study (the Zutphen Study). Ann Epidemiol. 1994;4:248 54.

Goswitz JT. Bacteria and biliary tract disease. Am J Surg. 1974;128(5):644-6.

Johnston DE, Kaplan MM. Pathogenesis and treatment of gallstones. N Engl J Med. 1993;328:412-21.