Nghiên cứu đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân sỏi đường mật tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To evaluate the clinical and paraclinical features of patients with gallstones (cholelithiasis). Subject and method: A combined retrospective and prospective study was conducted on 1,163 patients with 1,383 admissions at 108 Military Central Hospital from January 2021 to December 2022, assessing the treatment history, clinical characteristics, and paraclinical indicators. Result: Among the study population, 55.9% of patients had no history of surgical treatment or interventional treatment. The median age of patients was 62 years, with 60.4% of patients being over 60 years old. The male-to-female ratio was approximately equal. The main clinical symptoms were abdominal pain (84.2%), fever (47.7%), and jaundice (39.8%). Within the study population, 6.9% experienced hypotension, and 1.6% had consciousness disorders. Blood culture was performed on 15.8% of patients, with a positive rate of 50.5%. Imaging diagnosis revealed bile duct dilation in 80.7% of cases. The median size of common bile duct stones was 14mm, detected in 64.9% of patients, mostly with a quantity of less than 3 stones. In contrast, intrahepatic bile duct stones had a median size of 15mm, detected in 41.6% of cases, predominantly with multiple stones. Dangerous complications of gallstones included septic shock, septicemia, and severe cholangitis, observed in 7.7%, 8%, and 18.1% of cases, respectively. Pancreatitis occurred in 9.1% of patients. Conclusion: Gallstone disease is a common condition, particularly among elderly patients, and is associated with various dangerous complications. Recognizing and diagnosing the common clinical and paraclinical symptoms helps in early detection and diagnosis of the disease, thereby reducing the risk of severe complications.