A Clinical Review of Gallstone Diseases in Koreans

Kim, Gwang Ha; Ok, Chang Min; Kim, Byung Jin; Joo, Hyung Jun; Song, Chul Soo; Song, Guen Am; Cho, Mong; Yang, Ung Suk

Abstract

Background/Aitns: It has been reported frequently that clinical features of gallstone diseases in Koreans were different from those of Occidentals. These differences were thought to be due to inherent racial difference and acquired living habits. The purpose of this study is to evaluate whether the pattern of gallstone disease changes or not in Korea.
METHODS
We analyzed 5,488 cases of gallstone diseases which were reported in Korea frorn 1966 to 1994. We divided the period into 6 groups: the first period was 1,000 cases reported from 1966 to 1970, the second was 331 cases from 1971 to 1975, the third was 1,000 cases from 1976 to 1980, the fourth was 1,957 cases from 1981 to 1985, the fifth was 1,000 cases from 1986 to 1990, and the sixth was 200 cases from 1991 to 1993.
RESULTS
The age group of highest incidence was the fifth and sixth decade. The incidence below the third decade showed a decreasing tendency. In contrast, the incidence above sixth decade showed an increasing tendency. The male to female ratio was 1:1.25 to 1:1.71 and had no periological change. The duration of illness of highest frequency was below 6 months. In the case of duration above 5 years these was a decreasing tendency. The major complaints of biliary stone were right upper quadrant pain and tenderness. Nausea, vomiting, jaundice, and radiating pain showed a decreasing tendency. The major laboratory findings were leukocytosis, elevated SGOT and SGPT, elevated alkaline phosphatase, hyperbilirubinemia and hypoalbuminemia. Of these, only hypoalbuminernia had a decreasing tendency. By the second period, the main diagnostic procedures were oral cholecystogram and intravenous cholecysto- graphy. From the fourth period, ultrasonography, ERCP, CT and PTC were been used comrnonly. For the location of gallstone, the gallbladder stone revealed the only increasing tendency, the common bile duct stone had a decreasing tendency, and the intrahepatic duct stone had no periological change. From 1980, the cholesterol stone became the main composition of gallstones. But, there was no periological change between early and late 1980s. Positive bacterial culture rate was 57.0% and the most common microorganism was E. coli. Klebsiella and Enterobacter. Pseudomonas showed an increasing tendency. Of the diseases associated with gallstone, only diabetes had an increasing tendency. The frequency of residual stone had an increasing tendency.
CONCLUSIONS
The age of peak incidence of gallstone diseases was the fifth and sixth decades and there was a little predominance in females. From 1980, the cholesterol stone becarne the main composition of gallstones. For the location of gallstone, the gallbladder stone showed an increasing tendency and the common bile duct stone revealed a decreasing tendency. These suggested clinical features of gallstone diseases in Koreans are somewhat similar to those of Occidentals.