Spectrum of Gallstone Disease and Early Outcomes Following Laparoscopic Cholecystectomy: A Hospital-Based Prospective Observational Study.

Srinivasa Rao Gurugubelli; Venkata Badipatla; Manoj Sistu

doi:10.51168/s28amv30

Autori

Srinivasa Rao Gurugubelli Associate Professor Department of General Surgery NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India
Venkata Badipatla Associate Professor, Department of General Surgery, Maharajah's Institute of Medical Sciences Nellimarla, Vizianagaram, Andhra Pradesh, India
Manoj Sistu Assistant Professor, Department of General Surgery, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/s28amv30

Cuvinte cheie:

Gallstone disease, Cholelithiasis, Laparoscopic cholecystectomy, Acute cholecystitis, Chronic calculous cholecystitis, Surgical outcomes

Rezumat

Background

Gallstone disease remains one of the most frequent benign biliary disorders requiring surgical treatment. Laparoscopic cholecystectomy is the preferred operative approach, but clinical presentation, intraoperative difficulty, and early recovery vary across patients.

Objectives

To describe the clinical spectrum of gallstone disease and assess early postoperative outcomes among patients undergoing laparoscopic cholecystectomy

Methods

This single-centre, hospital-based prospective observational study was conducted at NRI Institute of Medical Sciences, Sanghivalasa, Visakhapatnam, Andhra Pradesh, India, from January 2025 to December 2025. A total of 100 adults with gallstone disease undergoing laparoscopic cholecystectomy were enrolled consecutively and followed for early postoperative outcomes through 30 days. Demographic, clinical, ultrasonographic, intraoperative, postoperative, readmission, and mortality data were analysed using descriptive statistics.

Results

The mean age was 44.8 ± 12.6 years, and females constituted 64.0% of patients. Overweight or obesity was present in 70.0%. Right upper quadrant pain was the commonest symptom (92.0%). Chronic calculous cholecystitis was the leading diagnosis (64.0%), followed by acute calculous cholecystitis (18.0%). Multiple stones were seen in 66.0%, and gallbladder wall thickening in 30.0%. Mean operative duration was 51.6 ± 14.8 minutes. Dense adhesions were observed in 28.0%, difficult Calot’s triangle in 14.0%, and conversion to open surgery in 2.0%. Most patients resumed oral liquids within 6 hours (76.0%) and were discharged within 2 days (72.0%). Port-site infection occurred in 5.0%, bile leak in 1.0%, and no mortality was recorded.

Conclusion

Gallstone disease predominantly affected middle-aged women and commonly presented as chronic calculous cholecystitis. Laparoscopic cholecystectomy showed favourable early outcomes with low conversion, limited morbidity, short hospital stay, and no mortality.

Recommendations

Routine preoperative ultrasonographic risk assessment, careful Calot’s triangle dissection, and structured postoperative follow-up are recommended to strengthen surgical safety and early recovery.

Biografii autori

Srinivasa Rao Gurugubelli, Associate Professor Department of General Surgery NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

is an Associate Professor in the Department of General Surgery at NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India. He is actively involved in undergraduate and postgraduate teaching, clinical surgical practice, and academic research. His areas of interest include general surgical disorders, perioperative care, abdominal surgeries, and clinical outcome-based surgical research. He has contributed to patient care through evidence-based surgical management and continues to support academic training, clinical documentation, and research activities in the field of general surgery. ORCID iD : https://orcid.org/0009-0006-6498-0767
Venkata Badipatla, Associate Professor, Department of General Surgery, Maharajah's Institute of Medical Sciences Nellimarla, Vizianagaram, Andhra Pradesh, India

is an Associate Professor in the Department of General Surgery at Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India. He is engaged in surgical patient care, medical education, clinical research, and academic training. His professional work includes the evaluation and management of patients with general surgical conditions and participation in institution-based research activities.
Manoj Sistu, Assistant Professor, Department of General Surgery, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India

is an Assistant Professor in the Department of General Surgery at NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India. He participates in undergraduate teaching, clinical services, surgical training, data collection, and academic research. His work focuses on evidence-based surgical practice and the clinical management of patients with common general surgical disorders.

Referințe

1. Lammert F, Gurusamy K, Ko CW, Miquel JF, Mendez-Sanchez N, Portincasa P, et al. Gallstones. Nat Rev Dis Primers. 2016;2:16024. https://doi.org/10.1038/nrdp.2016.24

2. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep. 2005;7(2):132-140. https://doi.org/10.1007/s11894-005-0051-8

3. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-187. doi:10.5009/gnl.2012.6.2.172.https://doi.org/10.5009/gnl.2012.6.2.172

4. Aune D, Norat T, Vatten LJ. Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol. 2015;30(9):1009-1019. https://doi.org/10.1007/s10654-015-0081-y

5. Pak M, Lindseth G. Risk factors for cholelithiasis. Gastroenterol Nurs. 2016;39(4):297-309. PMID:27467059.

https://doi.org/10.1097/SGA.0000000000000235

6. Gallaher JR, Charles A. Acute cholecystitis: a review. JAMA. 2022;327(10):965-975. doi:10.1001/jama.2022.2350.

https://doi.org/10.1001/jama.2022.2350

7. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018;25(1):41-54.

https://doi.org/10.1002/jhbp.515

8. Okamoto K, Suzuki K, Takada T, Strasberg SM, Asbun HJ, Endo I, et al. Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018;25(1):55-72. doi:10.1002/jhbp.516.

https://doi.org/10.1002/jhbp.516

9. Wakabayashi G, Iwashita Y, Hibi T, Takada T, Strasberg SM, Asbun HJ, et al. Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018;25(1):73-86. https://doi.org/10.1002/jhbp.517

10. Gurusamy KS, Samraj K, Gluud C, Wilson E, Davidson BR. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Cochrane Database Syst Rev. 2013;(6):CD005440. https://doi.org/10.1002/14651858.CD005440.pub3

11. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-1457. https://doi.org/10.1016/S0140-6736(07)61602-X

12. Mehraj A, Naqvi MA, Feroz SH, Rasheed H. Laparoscopic cholecystectomy: an audit of 500 patients. J Ayub Med Coll Abbottabad. 2011;23(4):88-90. PMID:23472423. 13. Yi F, Jin WS, Xiang DB, Sun GY, Dai H. Complications of laparoscopic cholecystectomy and its prevention: a review and experience of 400 cases. Hepatogastroenterology. 2012;59(113):47-50.

https://doi.org/10.5754/hge11232

13. Genc V, Sulaimanov M, Cipe G, Basceken SI, Erverdi N, Gurel M, et al. What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics (Sao Paulo). 2011;66(3):417-420. https://doi.org/10.1590/S1807-59322011000300009