STATISTICAL COMPARISON, CLINICAL PRESENTATION AND PROGNOSIS OF SINGLE AND MULTIPLE- STONES, CHOLOELITHIASIS

In spite of the common concept that all types of cholelithiasis have fairly similar clinical signs and symptoms, we noticed quite a difference in their clinical presentation and prognosis between the two groups of patients that had multiple stones (group I) or single stone (group II) cholelithiasis.
To varfiy this clinical assumption, we reviewed 125 patients which underwent cholecystectomy with the diagnosis of gall - stones in a two - year periode in Firoozgar Hospital and extracted the following results. The patients with choledocholithiasis and other biliary tract pathology excluded from the study.
The incidence of multiple stones (group I) was higher than the single stones (group II) patients, (69%Vs.31%).
The overall incidence of cholelithiasis was seven times higher in women (l06 women and 16 men) which is twice higher than the international statistics. The group II patients were mostly over weight and the incidence was twice higher than group I patients. The pain in group II patients was mostly constant and located in epigastrium but the pain in group I patients was mostly located in right upper quadrant and was colicky in nature. The number of patients in group II in our study was twice higher than the international statistics.
The group II patients were 10 years younger than the group I patients, and had less associated diseases.
The prognosis was also must worse in group II patients. So it should not be assumed that the patients with a single gall stone have less symptoms and better prognosis and is advised to give them priority in surgery.