Cholelithiasis in southern Sindh, Pakistan: incidence and composition of gallstones

ABSTRACT

To determine the surgical incidence and composition of gallstones at the Liaquat Medical College Hospital, Jamshoro [Hyderabad]. Design; A 3-year retrospective study of cholelithiasis and analysis of 77 gallstones by infrared spectroscopy. Setting: Surgical Units, Liaquat Medical College Hospital and Department of Biochemistry, University of Si. Subjects: Three hundred fifty seven consecutive cholelithiasis patients treated in the Surgical Units of Liaquat Medical College Hospital, Jamshoro. Main outcome measures: Surgical incidence of cholelithiasis with regard to epidemiological risk factors, composition of gallstones by age and sex of patients. The surgical incidence for cholelithiasis was found to be 3.07% [1.9% among males and 10.7% among females]. The highest female to male ratio [71] was seen in 20-29 year age group and the maximum prevalence of the disease in both sexes occurred between 30-39 years age. August to November were the peak months for the presentation of cholelithiasis patients. IR analysis of 77 gallstones disclosed that 60 [77.92%] including 41 [53.25%] pure cholesterol stones, contained cholesterol as a major constituent. The remainder 17 [22.08%] gallstones were mainly composed of bilirubin and calcium salts. Both cholesterol and pigment stones were preponderantly seen in patients between 40-59 years age. Pure cholesterol stones predominantly occurred in females than in males, while reverse was true for pure pigment stones. The present results reflect a better understanding of epidemiology and composition of gallstones of this area and further to decide whether to treat gallstone patients therapeutically or surgically