Assessment of gallstone predictor: comparative analysis of ultrasonographic and biochemical parameters (original) (raw)

A cross sectional study on the risk factors of gallbladder stone

International Journal of Research in Medical Sciences, 2016

Gallstone diseases are one of the most common public health problems. Approximately 10%-20% of the national adult populations currently carry gallstones, and gallstone prevalence is rising. In addition, nearly 750,000 cholecystectomies are performed every year in the United States; crude costs of gallbladder surgery are estimated to be $6.5 billion. 1,2 Cholelithiasis is also strongly associated with gallbladder, pancreatic and colorectal cancer occurrence. Moreover, the National Institutes of Health estimates that almost 3,000 deaths (0.12% of all deaths) per year are attributed to complications of cholelithiasis and gallbladder disease. Although extensive research has tried to identify risk factors for cholelithiasis, several studies indicate that definitive findings still remain elusive. 3 In this review, predisposing factors for cholelithiasis are identified, the pathophysiology of gallstone disease is described, and nonsurgical preventive options are discussed. Understanding the risk factors for cholelithiasis may not only be useful in assisting nurses ABSTRACT Background: Gallstone diseases are one of the most common public health problems. Approximately 10%-20% of the national adult populations currently carry gallstones, and gallstone prevalence is rising. The purpose of the study was to find out association of gallstone with fatty liver, gender and age in Lahore, Pakistan. Methods: Ultrasonographically Hundred patients were scanned for liver type and gall stone. The data was analyzed by using SPSS version 17.0. Chi-Square statistics was used to check the association between the variables. The effect of age and gender was also statistically analysed. Results: One hundred patients were scanned between ages 21-60 years. Out of hundred 76% patients were female and 24% were male. In this study there were no stones in 37% cases and there were stones in 63% cases. Gallbladder stone found associated with age as p-value is found less than 5% level of significance, maximum patients were found in age ranges between 31-35 years, showing that risk of developing gallstone increases by age. Gallstone is gender specific, females are more victims of developing the stone than among males, and those who have fatty liver are more at risk of developing gallstone than those having normal liver. Conclusions: The study showed that ultrasound (US) is the most sensitive, specific, yet very practical and useful imaging test for the detection of gallstones with a high degree of confidence. Gallstones represent high prevalence disease in adult females more than males and it increases by age where as those who have fatty liver, they are more likely to develop gallstone.

Prediction of Common Bile Duct Stones by Noninvasive Tests

Annals of Surgery, 1999

To define accurate and useful predictors of common bile duct stones (CBDS). Summary Background Data The ability to predict CBDS with noninvasive tests can avoid unnecessary, costly, or risky procedures. Methods All patients referred for examination for CBDS by endoscopic ultrasonography (EUS) from 1993-1996 were prospectively entered in a database. In a first sample selected randomly from the whole population, predictors of CBDS were determined by univariate analysis and logistic regression. Predictors were subsequently tested in that sample and in the rest of the population. A separate analysis was done for patients planned for cholecystectomy. Results Eight hundred and eighty patients (328 men, 552 women), aged 57.8 ± 17 years (range 16-94), were included. The prevalence of CBDS was 18.8%. Age, serum levels of bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase (GGT), and alkaline phosphatase, and the existence of jaundice and fever, a dilated bile duct, and a pathologic gallbladder were found to be associated with CBDS. Logistic regression was undertaken separately for patients younger than 70 years (predictors: GGT >7xnormal; pathologic gallbladder; dilated bile duct) and older than 70 years (predictors: GGT >7xnormal; fever > 380C; dilated bile duct). Odds ratios were 3 to 6.7. The model was satisfactorily applicable to the second sample; age <70 years: x2 = 3.3 (NS); age >70 years: x2 = 3.8 (NS). In patients younger than age 70 and planned for cholecystectomy, the combination of the level of GGT and dilated bile duct predicted CBDS accurately. Conclusions A simple screening of patients at risk for CBDS can be achieved with three predictive criteria adapted for the patient's age. Gallstone disease is a very common condition involving roughly 15% of the population in Europe and Northern America.1 In 10% to 15% of cases, cholelithiasis is complicated by the presence of common bile duct stones. Although there is no consensus on this point, many investigators believe that ductal stones should always be removed because of the high risk of complications such as cholangitis or acute pancreatitis.24 The circumstances in which common duct stones are revealed can be schematized as follows:

Body Mass Index and Gallbladder Stone

2013

The aim of this study was to analyse the performance of ultrasonography in the diagnosis of acute cholecystitis.We performed an observational retrospective study which included100 patient with clinical suspected of AC were randomized into two groups. The first group included these patients with final diagnosis of acute cholecystitis and other group included patients with final alternative diagnosis to acute cholecystitis. Study found that the incidence of AC is high in obese, AC incidence is higher within the age of 41-50 years, female (57%) more affected, Khartoum population suffer more than Omdurman and Kassala (71%), also tenderness is observed on examination with 38% and is not exist with 61% . it concluded that ultrasound had a great value in increasing accuracy in diagnosis of acute cholecystitis and it decreases the false negative diagnostic rate and improves the clinical outcome.

"Comparative Study Between Preoperative Clinical & Ultrasonogram and Per Operative Laparoscopic Findings in Gall Stone Disease"

Original Research Article Introduction: Gallbladder disease is a worldwide common surgical problem. Before the advent of the laparoscopic cholecystectomy, open cholecystectomy was the standard modality of treatment for cholelithiasis and symptomatic gallbladder diseases. Objective: To see the accuracy of clinical diagnosis after ultrasonographic evaluation of gallstone and symptomatic gallbladder disease. Materials and Methods: It is a prospective study the Patients admitted in surgery wards from emergency & outpatient department with the diagnosis of gallstone and symptomatic gallbladder disease. Total 100 patients were selected, who were admitted with the diagnosis of gallstone and symptomatic gallbladder diseases undergone laparoscopic cholecystectomy in Dhaka Medical College Hospital & BSMMU, Dhaka, Bangladesh. Patients were selected irrespective of their age, sex, fit for laparoscopic cholecystectomy. Results: This study represents the experiences with 100 patients who are admitted with the clinical and ultrasonographic diagnosis of gallstone and symptomatic gallbladder disease for laparoscopic cholecystectomy. Operation time was from 30-90 minutes with a mean time of 47.4 minutes. Typical clinical presentation was found in most of the cases. 15 (15%) patients presented with epigastric pain of which 12 (12%) patients were misdiagnosed and were treated for duodenal ulcer for years. 1 (1%) patient was diagnosed incidentally during ultrasonography for gynaecological complaints. All the patients in this study undergone ultrasonography of hepatobiliary system and pancreas. Out of 100 cases 93 (93%) cases were found to have stone in gallbladder sonologically, whereas 96 (96%) cases were found to have stone in the gallbladder peroperatively. Ultrasonography detected normal appearance gallbladder with stone in 73 (73%) cases but peroperatively found them in 76 (76%) cases. In 15 (15%) cases sonography revealed fibrosed and contracted gallbladder with stone, whereas 13 (13%) cases were found to have the findings per-operatively. Sonography commented 7 (7%) patients of thick gallbladder wall where per-operatively it was found in 11 (11%) patients. Distended gallbladder with stones was detected sonologically in 6 (6%) cases but peroperatively found them in 7 (7%) cases. In 1(1%) case sonography detected fibrosed and contracted gallbladder without stones but per-operatively such was found in 2 (2%) cases. Gallbladder polyp was found in 1 (1%) case both sonologically and peroperatively. No adhesions and stone in common bile duct were detected by sonologically. Conclusion: Considering and comparing data in this series it can be concluded that, sound clinical examination with ultrasonographic evaluation of gallstone and symptomatic gallbladder disease is almost accurate in real time laparoscopic cholecystectomy.

Comparative Study Between Preoperative Clinical and Ultrasonogram and Per Operative Laparoscopic Findings in Gall Stone Disease

SAS Journal of Surgery, 2020

Gallstones: Site, Size, Number, Prevalence and Complications by Ultrasonography

Journal of medical imaging, 2016

This study was undertaken to determine the common sites, sizes, number, complications and the prevalence of gallstones at Almadinah Almunawwarah in Saudi Arabia that is a common medical problem in this region even in young adults and not satisfied by enough previous studies. This was a descriptive retrospective study in which screening of 1018 case from the PACS system was done for gallstones. Those patients were subjected to abdominal ultrasound (US) imaging. The collected data analyzed by using the Microsoft word 2013 and SPSS. The prevalence of gallstones in this study is 18-23.5% and exactly 69.57% of gallstones were in females and 30.43% in males. Gallstones increase with age to peak in elderly. Approximately 58.15% of gallstones were multiple stones in the gallbladder and 39.13% were solitary stone. Nearly 61.41% were mobile stones in the gallbladder, 11.41% were impacted stones in the neck of the GB and 13% of the gallstones were filling the whole lumen of the GB. Approximate...

Practical recommendations for the prediction and management of common bile duct stones in patients with gallstones

Surgical Endoscopy, 2001

Background: Approximately 10% of patients with symptomatic gallstones may have associated common bile duct stones (CBDS). However, the predictive value of noninvasive tests as well as the preoperative diagnosis and management of CBDS have not been well defined. The aim of this study was to define an accurate and simple model for the prediction and management of CBDS. Methods: A prospective database containing 986 cholecystectomies performed from 1994 through 1999 was evaluated. Univariate analysis using the Pearson chi-square test was performed to determine the factors significantly related to the presence of CBDS. Then logistic regression analysis was performed for multivariate analysis to discover independent predictors. Results: Of the 986 patients in this study, 48 (5%) had CBDS. Of the 48 patients with choledocholithiasis, 22 (46%) were men and 26 (54%) were women. The mean age was 55.3 years (range, 16-87 years). As a result of multivariate analysis, abdominal ultrasonographic findings suggestive of CBDS (common bile duct diameter exceeding 8 mm or visible stones), total bilirubin, and gamma glutamyl transpeptidase levels above normal were the independent predictors of CBDS in patients age 70 or younger. On the other hand, an elevated bilirubin level was found to be the single independent factor related to CBDS in the elderly. Conclusions: For patients with gallstones, suggestive ultrasonographic findings in those younger than 71 years and elevated direct or total bilirubin level in those older than 70 years are the most valuable and practical predictors of CBDS, and thus are the proper indications for preoperative endoscopic retrograde cholangiography.

A survey on concomitant common bile duct stone and symptomatic gallstone and clinical values in Shiraz, Southern Iran

Advanced Biomedical Research, 2016

Background: Common bile duct stone (CBDS) as a result of gallstone is one of the gastrointestinal disorders. In this study, the incidence of CBDS and symptomatic gallstone in Shiraz were investigated, and their management suggested. Materials and Methods: This is a retrospective study that enrolled among 560 patients. The incidence of gallstone together with CBDS was evaluated using an ultrasonography studyand clinical data in the period between March 2014 and 2014 in Shiraz. Comparison between data was done using Student's t-test or Chi-square test. Results: Of these patients, 18.6% were male, and 81.4% were female with a mean age of 47.67 ± 0.74 years. The concomitant rate of gallstone and CBDS was 8.6%. 6.8% of patients with concomitant of gallstone and CBDS showed symptoms while 1.8% had not been diagnosed before the operation. The mean of serum alkaline phosphatase level in patients with the only gallstone was 255.80 IU/L and patients with concomitant gallstone, and CBDS was 580.88 IU/L with a significant difference between two groups (P < 0.001). Furthermore, liver function tests (aspartate aminotransferase, alanine transaminase) showed a significant difference between two groups of patients (P < 0.01, P < 0.001). Conclusions: Clinical variables such as tenderness, fever, and Morphy sign were more severein patients with concomitant gallstone and CBDS. The concomitant rate of gallstone and CBDS in our society is less that Western countries and asymptomatic patients showed fewer ratios than other countries. We think the approach for asymptomatic CBDS patients with gallstone can be affected by our results.

Effective diagnosis for the management of gall stone: a clinical study

International Surgery Journal, 2017

Background: Gallstones also known as cholelithiasis, is one of the most occurring and costly gastrointestinal disorder. Management of acute biliary cholelithiasis mainly involves pain control with non-steroidal anti-inflammatory drugs or narcotic pain relievers. However, surgical procedures like laparoscopic and mini-laparotomy cholecystectomy is also use for the management of it.Methods: Present clinical study gives an account of the diagnostic criteria for the effective management of acute biliary cholelithiasis, the diagnosis of gallstones was done by ultrasonography (USG).Results: Present study indicated females more (73.33 %) prone to occurrence of gallstone compared to males (26.67 %). Abdominal pain was the common feature in all the patients, with majority complaining (40 %) pain in right hypochondrium and epigastrium. Dyspepsia along with Nausea and vomiting was associated in 70 % and 66.66 % patients respectively. Tenderness and tenderness of hypochondrium were reported in ...

Assessment of gallstone predictor: comparative analysis of ultrasonographic and biochemical parameters (original) (raw)

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