Morphological spectrum of gallstone disease in 1100 cholecystectomies in North India

Background: Gallstones are a major cause of morbidity and mortality throughout the world. In India, they are seven times more common in the North as compared to the South. Aims: To study the morphological spectrum of gallstone disease in the stonebelt of India, and to understand its probable etiopathogenesis. Materials and Methods: Morphological spectrum of gallstone disease was studied in 1100 cholecystectomies over a period of 3 years in the past. Results: There was a preponderance of females (M : F ratio 1 : 6.4). The age of the patients varied from 10 to 90 years with maximum number of cases between 31 and 40 years of age. On morphological analysis, gallstones were of mixed type in 686 cases (62.3%), pigment type in 34 cases (3.2%), cholesterol type in 182 cases (17.3%), and combined type in 148 cases (14%). Other lesions associated with chronic cholecystitis were cholesterolosis in 112 cases (10.1%), xanthogranulomatous cholecystitis in 26 cases (2.3%), follicular cholecystitis in 26 cases (2.3%), ceroid granulomas in ten cases (0.9%), eosinophilic cholecystitis in six cases (0.5%), and carcinoma in 12 cases (1.09%). Maximum number of carcinomas were associated with pigment stones, that is, 7 out of 12 cases (58.3%). Conclusions: The morphological spectrum of gallstone disease in this stone-belt of India will certainly contribute to understand its etiopathogenesis, and hence prevention. However, further studies on the biochemical composition of stones and their association with morphological changes are required to clarify the etiopathogenesis.