ISPUB.COM The Internet Journal of Surgery Volume 14 Number 2 1 of 4 Correlation Of Gallstone Disease With Iron-Deficiency Anaemia: A Prospective Study S Sahu, R Jain, A Prakash, D Bahl, P Sachan Citation S Sahu, R Jain, A Prakash, D Bahl, P Sachan. Correlation Of Gallstone Disease With Iron-Deficiency Anaemia: A Prospective Study. The Internet Journal of Surgery. 2007 Volume 14 Number 2. Abstract Gallstone disease is a common clinical entity affecting the adult population of both sexes. Conditions that favor the formation of cholesterol gallstones are super-saturation of bile with cholesterol, kinetically favorable nucleation and the presence of cholesterol crystals in the gall bladder long enough to agglomerate into a stone. Recent studies have defined the role of trace elements (Fe, Ca, Zn, and Cu) and defective pH in the formation of gallstones. The aim of the study was to correlate iron- deficiency anemia with gallstone disease. This prospective study of 100 patients was conducted over a period of 12 months in the Department of Surgery and Department of Biochemistry, Himalayan Institute of Medical Sciences, Dehradun, India. Serum and gallbladder biliary cholesterol levels were compared with gallstone patients having normal and low serum ferritin level. Gallbladder cholesterol level was significantly higher in anemic, than in non-anemic patients. Low serum iron level is a factor in bile super-saturation with respect to cholesterol leading to gallstone formation. INTRODUCTION Gallstone disease is a common clinical entity affecting the adult population of both sexes. The earliest known gallstones date back to the 21 st Egyptian dynasty discovered in the mummy of a priestess of Amenen (1085-945 BC). Gallstones are classified into either pure cholesterol stones, black or brown pigmented stones or mixed stones. Conditions that favor the formation of cholesterol gallstones are super-saturation of bile with cholesterol, kinetically favorable nucleation and the presence of cholesterol crystals in the gall bladder long enough to agglomerate into stone. Recent studies have defined the role of trace elements (Fe, Ca, Zn, and Cu) and defective pH in the formation of gallstones. 1 , 2 AIM AND OBJECTIVE The aim of the study was to correlate iron deficiency anemia with gallstone disease. MATERIAL AND METHODS The prospective study was conducted over a period of 12 months in the Department of Surgery and Department of Biochemistry, Himalayan Institute of Medical Sciences, Dehradun, India. The research committee of the institute approved the study protocol. One hundred patients suffering from cholelithiasis admitted in the surgical ward and confirmed by ultrasonography were included in the study irrespective of their age, sex and parity. Both laparoscopic and open cholecystectomies were the procedures advocated for treatment. Patients suffering from empyema and mucocele of the gall bladder were excluded from this study. Serum iron, serum cholesterol and biliary cholesterol were estimated in all the patients. Serum iron was estimated by Ferrozine kit method. 9 The normal reference values were supplied with the kit, for males (60-160 ug/dl) and for females (35-145 ug/dl). Serum cholesterol was estimated by Enzopak kit based on cholesterol oxidase/peroxidase method as devised by Allain et al. 10 Biliary cholesterol was estimated after extraction of biliary lipids from bile from the gallbladder specimen of the patients by the method of Folch et al. which was followed by the procedure similar to the analysis of serum cholesterol by Enzopak Kit to estimate the biliary cholesterol level. 11 Based on the serum iron content, the patients with cholelithiasis were divided into two groups. Group A contained patients with normal serum iron and Group B iron deficient patients. Serum and biliary cholesterol contents of both groups were analyzed and compared with each other. RESULTS The gallstone sufferers were divided into two groups based