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Correlation of Surgical and Conservative Management of Cholelithiasis & its Varying Complications by Clinical Pharmacists in a South Indian Tertiary Care Teaching Hospital


Received On: 16/09/2018
Accepted On: 21/09/2018


Author(s)

Das, S. K., Suraj, S. S., Hajira, F., Gunnala, K., Munnangi, F.


Author's Affiliation

CMR College of Pharmacy, Knadlakoya(V), Medchal Road, Hyderabad – 501401. Telangana State, India.


Abstract

Cholelithiasis (Gall stone) is most frequent disorders of biliary tract, Cholelithiasis complications includes; Acute Cholecystitis, Choledocholithiasis & Cholangitis, Acute Pancreatitis and Intestinal Obstruction. These complication managed by surgical procedures or conservative methods. Laparoscopic Cholecystectomy is choice of procedure for shorter length of stay & faster convalescence period. Conservative method includes; oral dissolution therapy (Ursodeoxycholic acid for less than 5mm stone) and broad spectrum antibiotics with analgesics. Study was aimed to correlate the management approach for cholelithiasis & its varying complications by surgical procedure or conservative methods, to observe Cholelithiasis prevalence and to establish a pharmaceutical care plan. A prospective observational study conducted between September 2016 and February 2017 in the in-patient department of General Surgery, Gandhi Medical College and Hospital, Secunderabad. Patient data were documented in a structured format according to inclusion criteria. ANOVA statistical methods were performed for final outcome. In 104 cases, 67% were Cholelithiasis, 17% Choledocholithiasis and 13% Acute Cholecystitis. Study demonstrates female predominance, surgical and conservative management was 67% and 33% respectively. Laparoscopic Cholecystectomy (94%) was most preferred surgical procedure and Metronidazole & Ceftriaxone mostly prescribed antibiotics along with analgesic Tramadol. Hyoscine was commonly prescribed anti-spasmodic but Ursodeoxycholic acid prescription was minimal. Majority of stone size observed was within 10mm and maximum patient were obese or overweight. Management depends upon factors like; surgeon’s choice, stone size & pre-existing conditions. Clinical pharmacist can provide pharmaceutical care through counseling and education for obese patients to prevent recurrence. Overall management was satisfactory as nearly all patients got cured with negligible number of mortality or morbidity.


Keywords

Cholelithiasis, Surgical management, Conservative management, Clinical Pharmacist

Cite This Article

Das, S. K., Suraj, S. S., Hajira, F., Gunnala, K., Munnangi, F., Konde, A. (2018). Correlation of Surgical and Conservative Management of Cholelithiasis & its Varying Complications by Clinical Pharmacists in a South Indian Tertiary Care Teaching Hospital. International Journal for Pharmaceutical Research Scholars(IJPRS), 7(3); 123-135. http://dx.doi.org/10.31638/IJPRS.V7.I3.00066


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