PREVALENCE, CLINICAL PROFILE, DIAGNOSTIC EVALUATION, AND MANAGEMENT OF CHOLEDOCHOLITHIASIS AMONG PATIENTS WITH GALLSTONE DISEASE: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTRE IN SOUTH

Abstract

Background Choledocholithiasis remains one of the most important complications of gallstone disease because of its association with biliary obstruction, cholangitis, acute pancreatitis, and increased surgical morbidity. Early diagnosis using appropriate imaging and timely intervention are essential for preventing complications. This study aimed to determine the prevalence of choledocholithiasis among patients with gallstone disease and to evaluate their demographic characteristics, clinical presentation, diagnostic findings, management strategies, and short term outcomes. Methods A prospective observational study was conducted in the Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, between July 2024 and January 2026. Sixty-five adult patients with imaging confirmed gallstone disease were included. Clinical characteristics, laboratory investigations, ultrasonography, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), operative findings, treatment modalities, and postoperative outcomes were recorded using a standardized proforma. Data were analysed using descriptive statistics and appropriate inferential tests. Results Among the 65 patients studied, 42 were diagnosed with choledocholithiasis, giving an overall prevalence of 64.6%. The highest proportion of patients belonged to the 41–50-year age group (49.2%), and females predominated (60%). Right upper quadrant abdominal pain was the most common presenting symptom (100%), followed by nausea or vomiting (80.9%) and jaundice (50%). Elevated alkaline phosphatase was observed in 85.7% of patients. Ultrasonography detected common bile duct stones in 46.1% of patients, whereas MRCP demonstrated a sensitivity of 95.2%. ERCP achieved successful ductal clearance in 95.2% of treated patients and represented the most frequently employed therapeutic intervention (52.4%). Complete ductal clearance was achieved in 95.2% of cases with no mortality. Most patients (64.3%) were discharged within 4–7 days following treatment. Conclusions Choledocholithiasis was highly prevalent among patients with gallstone disease in this tertiary care population. MRCP demonstrated excellent diagnostic accuracy, while ERCP remained the preferred therapeutic modality with high success rates and low complication rates. Routine evaluation of patients with symptomatic gallstone disease using appropriate imaging facilitates early diagnosis and improves clinical outcomes.