Cholelithiasis, commonly referred to as gallstone disease, is a significant clinical problem with an increasing global prevalence [1]. It is characterized by the presence of calculi within the gallbladder, a condition that can lead to biliary colic, cholecystitis, and other severe complications if left untreated [2]. Gallstones are primarily classified into cholesterol, pigment, and mixed types based on their composition, with cholesterol gallstones being the most prevalent in Western countries [3,4]. 

Risk factors for cholelithiasis include age, female sex, obesity, rapid weight loss, diabetes, and dietary habits [5,6]. Additionally, genetic predisposition and lifestyle choices play a critical role in its pathogenesis [7]. The role of supersaturation of bile with cholesterol, gallbladder dysmotility, and bile stasis in stone formation is well-documented [8]. The introduction of advanced imaging techniques such as ultrasonography and endoscopic ultrasound has significantly improved diagnostic accuracy for gallstone detection [9,10].

Management of cholelithiasis ranges from conservative approaches, such as dietary modifications and oral bile acid therapy, to surgical interventions like laparoscopic cholecystectomy, which remains the gold standard [11]. Despite these advancements, complications such as gallstone pancreatitis, choledocholithiasis, and gallbladder cancer continue to pose challenges in clinical practice [12].

Recent advancements in diagnostic imaging and minimally invasive surgical techniques have significantly improved the outcomes for patients with gallstone disease. However, the decision-making process regarding the optimal management approach remains complex and necessitates a thorough understanding of the disease's natural history, patient-specific factors, and the potential risks and benefits of each treatment modality.

This clinical study aims to provide a comprehensive analysis of cholelithiasis, encompassing its epidemiology, pathophysiology, clinical presentation, diagnostic approaches, and management strategies. By synthesizing current evidence and clinical guidelines, this study seeks to enhance the understanding of gallstone disease and inform best practices for its management.

This study was conducted on 100 patients diagnosed with gallstone disease who underwent cholecystectomy at a tertiary care hospital. The data collection was carried out retrospectively by reviewing patient medical records to analyze demographic characteristics, clinical features, and types of gallstones, surgical methods, and post-surgical outcomes.

This retrospective study was conducted on 100 patients diagnosed with gallstone disease who underwent cholecystectomy at a tertiary care hospital. The objective was to analyze demographic characteristics, clinical presentations, types of gallstones, surgical methods, and post-surgical outcomes

Study Population: Patients of all genders and age groups diagnosed with gallstone disease and scheduled for cholecystectomy were included in the study. Those with incomplete medical records or significant co-morbidities unrelated to gallstone disease were excluded

Participants of all age groups and both sexes with a confirmed diagnosis of gallstone disease were included. Patients with incomplete records or unrelated severe systemic illnesses were excluded.

Inclusion Criteria:

Adults aged 18 years and above.

Patients diagnosed with gallstone disease undergoing cholecystectomy.

Participants providing informed consent.

Exclusion Criteria:

Incomplete or missing medical records.

Presence of unrelated severe systemic illnesses (e.g., advanced malignancies).

Patients not undergoing cholecystectomy.

Data Collection:

Demographic Details: Gender and age were categorized into 20–40 years, 41–60 years, and >60 years.

Clinical Features: Pain, nausea, vomiting, fever, and jaundice were recorded.

Type of Gallstones: Classified into cholesterol, pigment, or mixed stones based on histopathology.

Surgical Methods: Procedures were classified as open or laparoscopic cholecystectomy.

Post-Surgical Complications: Complications during hospital stays or follow-ups were documented

Data Analysis:

Descriptive statistics were used to analyze categorical data, including frequencies and percentages. The results were presented in tables for clarity.

Data Collection: The following parameters were collected:

Demographic Details: Gender was recorded as male or female, and age was categorized into three groups: 20–40 years, 41–60 years, and >60 years.

Clinical Features: Presenting symptoms were documented, including pain, nausea/vomiting, fever, and jaundice. Pain was considered a primary inclusion criterion, as it was universally present in this cohort.

Type of Gallstones: Gallstones were classified based on their composition into cholesterol stones, pigment stones, or mixed stones, as determined by histopathological examination and imaging findings.

Surgical Method: The type of surgery performed was categorized as open cholecystectomy or laparoscopic cholecystectomy, depending on the surgeon's decision and patient condition.

Post-Surgical Complications: Post-operative outcomes were assessed, with complications categorized as "Yes" (present) or "No" (absent). Complications included any adverse events observed during the hospital stay or follow-up period.

Data Analysis: Descriptive statistical methods were used to summarize the collected data. Frequencies and percentages were calculated for categorical variables, including gender, age groups, clinical features, types of gallstones, type of surgery, and post-surgical complications. Results were presented in tabular form for clarity and comprehensiveness.

Of the 100 patients considered for this study, two-third (66 %) patients were female and about one-third (34 %) patients were male.

Table 1   Gender

Close to half of the patients in this study (42 %) fell into the age group 41 – 60 years. Almost one-third of the patients (32 %) were from the age group 20 – 40 years and a little over one-fourth of the patients from this study (26 %) were aged more than 60 years.

Table 2   Age Group

All of the 100 patients (100 %) considered for this study had Pain, while more than two-third of the patients (69 %) experienced Nausea or Vomiting. Fever was observed in only 11 % patients and only 10 % patients had Jaundice.

Table 3   Clinical Features

Nearly half of the patients (47 %) considered for this study had Mixed Type of Stone. Pigment Stone was present in more than one-third (36 %) of the patients while Cholesterol Stone was observed in only 17 % of the patients.

Table 4   Type of Stone

Of the 100 patients considered for this study, nearly two-third of the patients (62 %) underwent Laparoscopic Cholecystectomy and the remaining 38 % patients had undergone Open Cholecystectomy.

Table 5   Type of Surgery

Almost all of the patients (90 %) had No Complications Post Surgery while only 10 % of the patients showed Complications Post Surgery.

Table 6   Complications Post Surgery

Gallstone disease is a common health issue affecting people worldwide, often presenting with symptoms like pain, nausea, vomiting, fever, and jaundice. It is more common in women, especially those in middle age, due to hormonal and metabolic factors. The types of gallstones—cholesterol, pigment, or mixed—vary, with mixed stones being the most frequent. Laparoscopic cholecystectomy has become the preferred surgical method, offering quicker recovery and fewer complications. Studying the patterns of gallstone disease helps in better diagnosis, treatment, and improving patient care.

In our study, 66 % of patients were female, and 34 % were male, indicating a higher prevalence among females. This aligns with findings from other studies that reported a predominance of gallstone disease in females, attributed to hormonal influences and differences in bile composition [13,14]. A study by Channa et al. found that 65 % of their cohort was female, consistent with our results [15].  The majority of patients (42 %) in our study were aged 41–60 years, followed by 32 % aged 20–40 years and 26 % aged above 60 years. Similar age distributions were observed in studies by Shaffer et al. [16] and Aerts et al. [17], who reported the highest prevalence of gallstone disease in middle-aged individuals due to metabolic and lifestyle factors.

Pain was the most common symptom in our study, reported by 100 % of patients, followed by nausea/vomiting (69 %), fever (11 %), and jaundice (10 %). These findings are consistent with those of Khan et al. [18], who reported pain as the primary presenting symptom in 95 % of patients, with nausea/vomiting observed in 70 % of cases. Fever and jaundice, although less frequent, were similarly reported as minor symptoms in studies by Strasberg et al. [19].

In our cohort, mixed stones were the most prevalent (47 %), followed by pigment stones (36 %) and cholesterol stones (17 %). Similar trends were observed by Channa et al. [15], who reported mixed stones in 50 %, pigment stones in 35 %, and cholesterol stones in 15 % of their cases. The predominance of mixed stones aligns with the global pattern reported in studies by Stinton et al. [20], who noted mixed stones as the most common type in gallstone disease.

Laparoscopic cholecystectomy was performed in 62 % of patients in our study, while 38 % underwent open cholecystectomy. This reflects the increasing preference for laparoscopic procedures due to reduced recovery time, fewer complications, and better patient outcomes. Studies by Yeo et al. [21] and Singh et al. [22] similarly reported laparoscopic cholecystectomy rates exceeding 60 %, consistent with our findings.

Post-surgical complications were observed in only 10 % of patients in our study, with 90 % reporting no complications. This is consistent with the findings of Gutt et al. [23], who reported a 10–12 % complication rate following laparoscopic cholecystectomy. The low complication rate in our study reflects the efficacy and safety of modern surgical techniques.  Laparoscopic cholecystectomy remains the preferred surgical approach, associated with minimal complications. These results reinforce the importance of adopting laparoscopic techniques and highlight the consistency of demographic and clinical patterns in gallstone disease across different populations.

The study results indicated that Gallstone disease predominantly affects females and middle-aged individuals, with pain being the most common symptom. Mixed stones are the most frequent type, and laparoscopic cholecystectomy remains the gold standard for management. Early detection, accurate diagnosis, and advancements in minimally invasive techniques contribute to improved patient outcomes, underscoring the need for continued research and refinement of treatment strategies.

Ethical Clearance: Ethical Clearance Certificate was obtained from the Institutional Ethics Committee (IEC) prior to commencement of study

Conflict of Interest: Nil - No conflict of interest

Source of funding: Self

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