GALLBLADDER DISEASES: COMPLICATIONS AND RISK FACTORS, A RETROSPECTIVE STUDY IN REHMAN MEDICAL INSTITUTE (RMI), PESHAWAR, PAKISTAN

Jamil Ahmad, Akash Kumar, Zubair Ahmad Khan, Khalid Saifullah Baig, Sarah Rahim, Muhammad Mohsin

Abstract


Background: Gallbladder pathologies significantly contribute to global morbidity, with cholelithiasis, calculous/acalculous cholecystitis, gangrene, and perforation representing common conditions. This study aimed to identify complications and risk factors influencing surgical outcomes in gallbladder disease patients.

Materials & Methods: We retrospectively analysed 42 patients undergoing open/laparoscopic cholecystectomy at Rehman Medical Institute (August 2021–July 2022). Statistical analysis used SPSS v26.

Results: Among patients (24 male, 18 female; mean age 58.74±16.049 years), abdominal pain (95.2%), nausea/vomiting (78.6%), and fever (61.9%) were predominant symptoms. Diagnoses included: Cholecystitis (54.8%), Gangrenous perforation (19.1%), Empyema (9.5%). Comorbidities (hypertension, diabetes, ischemic heart disease) showed peak prevalence in males aged 61–70 years (p<0.05).

Conclusion: Cholecystitis was the predominant pathology, with advanced age, leucocytosis, and cardiometabolic comorbidities serving as key risk factors. Early diagnosis and cholecystectomy remain critical for mitigating complications, particularly in elderly males.


Keywords


Cholecystectomy; Cholecystitis; Gallbladder; Complications; Diseases; Empyema; Perforation.

Full Text:

PDF

References


Williams NS, O'Connell PR, McCaskie A, editors. Bailey & Love’s Short Practice of Surgery [Internet]. 27th ed. Boca Raton (FL): CRC Press; 2021. p. 24. Available from: https://www.taylorfrancis.com/chapters/mono/10.1201/9781315111087-67/gallbladder-bile-ducts-professor-sir-norman-williams-professor-ronan-connell-professor-andrew-mccaskie

Ramachandra ML, Jabbar FA. Gall bladder perforation: occurrence, clinical presentation, diagnosis and their outcome: a retrospective study in a tertiary care hospital in South India. Int Surg J. 2019;6(2):369. https://doi.org/10.18203/2349-2902.isj20190385

Amreek F, Hussain SZM, Mnagi MH, Rizwan A. Retrospective analysis of complications associated with laparoscopic cholecystectomy for symptomatic gallstones. Cureus. 2019;11(7):e5152. https://doi.org/10.7759/cureus.5152

Acalovschi M, Lammert F. The growing global burden of gallstone disease. World Gastroenterol News [Internet]. 2022;17(4):6–8. Available from: https://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-growing-global-burden-of-gallstone-disease

Goyal V, Nagpal N, Gupta M, Kapoor R. A prospective study to predict the preoperative risk factors for conversion of laparoscopic to open cholecystectomy. Int J Contemp Med Surg Radiol. 2017;2(4):148–52.

Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg. 1993;165(4):399–404. https://doi.org/10.1016/S0002-9610(05)80930-4

Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002;325(7365):639–43. https://doi.org/10.1136/bmj.325.7365.639

Chandler CF, Lane JS, Ferguson P, Thompson JE, Ashley SW. Prospective evaluation of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Am Surg. 2000;66:896–900. https://doi.org/10.1177/000313480006600921

Wang AJ, Wang TE, Lin CC, Lin SC, Shih SC. Clinical predictors of severe gallbladder complications in acute acalculous cholecystitis. World J Gastroenterol. 2003;9(12):2821–3. https://doi.org/10.3748/wjg.v9.i12.2821

Mehraj A, Dar AH, Adnan Z, Anis M, Bashir S, Altaf A. Gender-based outcome of acute cholecystitis. J Surg Pak (Int). 2017;22(1):8–11. https://doi.org/10.21699/jsp.22.1.3

Derici H, Kamer E, Kara C, Ünalp HR, Tansuǧ T, Bozdaǧ AD, et al. Gallbladder perforation: clinical presentation, predisposing factors, and surgical outcomes of 46 patients. Turk J Gastroenterol. 2011;22(5):505–12. https://doi.org/10.4318/tjg.2011.0246

Parker LJ, Vukov LF, Wollan PC. Emergency department evaluation of geriatric patients with acute cholecystitis. Acad Emerg Med. 1997;4(1):51–5. https://doi.org/10.1111/j.1553-2712.1997.tb03643.x

Trowbridge RL, Rutkowski NK, Shojania KG. Does this patient have acute cholecystitis? JAMA. 2003;289(1):80–6. https://doi.org/10.1001/jama.289.1.80

Menakuru SR, Kaman L, Behera A, Singh R, Katariya RN. Current management of gall bladder perforations. ANZ J Surg. 2004;74(10):843–6. https://doi.org/10.1111/j.1445-1433.2004.03186.x

Sood BP, Kalra N, Gupta S, Sidhu R, Gulati M, Khandelwal N, et al. Role of sonography in the diagnosis of gallbladder perforation. J Clin Ultrasound. 2002;30(5):270–4. https://doi.org/10.1002/jcu.10071

Ahmad ME. Incidence of the complications, factors predisposing to, and the rate of conversion of laparoscopic cholecystectomy to open cholecystectomy. Int J Curr Res Med Sci. 2017;5(10):28660–3.

Shi X, Jin S, Wang S, Tao W, Wang G. Gallbladder perforation in a patient with alcoholic liver cirrhosis and asymptomatic gallstones. Medicine (Baltimore). 2018;97(18):e10414. https://doi.org/10.1097/MD.0000000000010414

Date RS, Thrumurthy SG, Whiteside S, Umer MA, Pursnani KG, Ward JB, et al. Gallbladder perforation: case series and systematic review. Int J Surg [Internet]. 2012;10(2):63–8. https://doi.org/10.1016/j.ijsu.2011.12.004

Khan SA, Gulfam, Anwer AW, Arshad Z, Hameed K, Shoaib M. Gall bladder perforation: a rare complication of acute cholecystitis. J Pak Med Assoc. 2010;60(3):228–9.




DOI: https://doi.org/10.46903/gjms/23.3.1600

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025. Zubair Ahmad Khan

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan

ISSN: 1819-7973, e-ISSN: 1997-2067

Website: https://www.gmcdikhan.edu.pk

Phone: +92-966-747373

Scimago Journal & Country Rank