Friday, June 16, 2023

In India, the prevalence of gallstones stands at 6.12% (3% in males and 9.6% in females)

 


8 cms Gall Stone removed from a 51-year-old Man at Apollos, Navi Mumbai

Navi Mumbai, 15 June 2023:  Doctors at Apollo Hospitals, Navi Mumbai successfully removed an 8 cm stone from the gall bladder of a 51-year-old man. The patient complained of persistent pain and bloating in the abdomen with general discomfort for 3-4 months and had consulted several healthcare professionals but didn’t get any relief.  Further evaluation by Dr. Nitish Jhawar, Consultant Laparoscopic & Robotic Surgery, Apollo Hospitals, Navi Mumbai led to the diagnosis of a massive gallstone.


Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. Researchers do not fully understand the reason for these changes in bile. Gallstones also may form if the gallbladder does not empty completely or often enough. Certain people are more likely to have gallstones than others due to risk factors such as obesity and certain kinds of diets. If left untreated, gallstones can grow and potentially develop into cancerous forms. They may also become impacted in the common bile duct, leading to complications such as choledocholithiasis, cholangitis, and pancreatitis. Gall bladder cancer can be challenging due to the absence of prominent symptoms and a delayed diagnosis can result in a poor prognosis and reduced life expectancy.


In India, the prevalence of gallstones stands at 6.12% (3% in males and 9.6% in females). While some individuals remain asymptomatic, many cases go undiagnosed until severe symptoms significantly impact daily functioning. As the patient did not get relief from symptomatic treatments and the symptoms aggravated over time, a comprehensive investigation was undertaken leading to a temporary diagnosis of jaundice. Further evaluation through Ultrasonography (USG) facilitated the definitive diagnosis of a massive gallstone measuring 8 cm. A laparoscopic removal of the gallstone was recommended to the patient.


Dr. Nitish Jhawar, Consultant Laparoscopic & Robotic Surgery, Apollo Hospitals, Navi Mumbai, said, “There are several misconceptions about gallstone surgery in India. Some believe that the surgery is unnecessary in the absence of significant symptoms. Others believe the surgery may cause permanent damage to the digestive system and some may not opt for it due to financial constraints. The patient also initially hesitated to undergo surgery due to these prevalent misconceptions. However, he eventually consented and underwent a laparoscopic procedure. Usually, the size of gall stones is equivalent to small grains. During the operation, we discovered a gallstone, the shape of a medium-sized cucumber, measuring 8 x 8 cm2 and weighing 840 milligrams.”


Mr. Santosh Marathe, Regional CEO – Western Region, Apollo Hospitals, Navi Mumbai, said, “This case carries significant clinical significance, emphasizing the importance of regular health check-ups and timely interventions needed as large stones can carry the risk of being cancerous and if untreated can result in emergency situations. Apollo Hospitals, Navi Mumbai remains committed to providing exceptional medical care and achieving the best outcomes. AHNM has the most technologically advanced infrastructure to support laparoscopic minimally invasive procedures coupled with 4th generation Da Vinci Xi robotic system. All these ensure faster and safer treatment modalities for our patients. The hospital's experienced medical professionals and comprehensive post-operative care ensure the highest standards of surgical interventions for patients.”

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