Krishna Kant Singh
Biliary calculus disease is the commonest morbidity effecting gasterointestinal tract, in the last century gallstoes disease has shown marked elevation with significant demographic variation in the prevalence rates which varies from 15-25%. The pathogenesis of gallstones is multi-factorial also depends on the type of gallstones, in different studies there is a high variation in the incidence of type of gallstones ranging from cholestrol, 6% to 65%, pigment- 3% to 77%, and mixed 17% to 56%. In some studies in 50% cases bile & center of gallstones tested positive and the isolates were- E.coli, Klebsiella, Citrobacter, Enterococcus, Pseudomonas, these studies included both acute and chronic cholecystitis. In other studies show that bile positivity is more in acute cholecystitis. We could not find credible literature on the associationship between type of gallstones and the microbiological spectrum in bile, one such study was done in Tamilnadu but the sample size was only 50, moreover no such study could be found for Northern India. This motivated us to undertake this study in North India and study the deviations in incidences of predisposing factors and of type of gallstones, incidence of bile positivity and associationship between type of stone and the microbiologial spectrum for only in chronic calculus cholecystitis
Conclusion: 1. Middle aged female predominance of this study is in accordance with literature. 2. Bile culture tested positive in 20% cases this is much less than the literature values, commonest isolated organism Ecoli, in accordance to literature. 3. No significant associationship was noted between bacteriological organisms and type of stone. 4. In our study the incidence the cholesterol stone noted as 68% which is much higher than other documented studies. 5. In North India bile positivity is less and incidence of cholesterol stone is very high. Further studies are needed for the comparative study of bile positivity in acute and chronic cholecystitis. Large Study needed to study relationship of type of gall stones and bacteriological spectrum.`
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