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Major Intraoperative Complications of Cholecystectomy in a Teaching Hospital, Addis Ababa, Ethiopia
Abstract
Background: Gall stone disease is one of the commonly handled surgical pathologies by a General Surgeon. Major intra operative complications are less commonly encountered in experienced hands. The rate may increase in a teaching hospital where Residents are allowed to operate. Therefore it was with this assumption that a study was carried to assess the incidence and contributing factors for the complications in a tertiary teaching hospital.
Methods: A retrospective chart and operation log book review was done in a two -year period between January 2009 and December 2010 in St Paul’s teaching hospital, AA, Ethiopia.
Results: A total of 645 cholecystectomy, 588(91.2%) open and 57(8.8%) laparoscopic, were done in the study period. Females comprised 80.9% of the patients. The average age of the patients was 42.8 years with a range of 18 to 80. Major surgical complications were seen in 19(2.9%) patients but adequate information was found for 16 patients only with a retrieval
rate of 84.2 %. Of the 16 patients 14(87.5%) were female. Thirteen patients had open cholecystectomy and the rest 3 patients had laparoscopic cholecystectomy. Accordingly the rate for open cholecystectomy was 13/588(2.21%), and that of laparoscopic surgery
3/57(5.26%). Twelve (92.3%) of the complicated cases in open cholecystectomy were done by residents alone. The rate of complications for the consultants in open surgery was 0.2% and that of the residents 6.0%. The odd that patients operated by residents will develop IBDI was 6.25 times higher than that of the seniors. There is statistically significant
association between seniority and major surgical complications(X2= 11.91, P=0.001).
Conclusions: The incidence of major complications of cholecystectomy is unacceptably high in this study. Almost all complications occurred in the hands of residents which show that experience matters. Therefore it is our recommendation that residents should not be left alone until they get reasonable experience in the field.
Methods: A retrospective chart and operation log book review was done in a two -year period between January 2009 and December 2010 in St Paul’s teaching hospital, AA, Ethiopia.
Results: A total of 645 cholecystectomy, 588(91.2%) open and 57(8.8%) laparoscopic, were done in the study period. Females comprised 80.9% of the patients. The average age of the patients was 42.8 years with a range of 18 to 80. Major surgical complications were seen in 19(2.9%) patients but adequate information was found for 16 patients only with a retrieval
rate of 84.2 %. Of the 16 patients 14(87.5%) were female. Thirteen patients had open cholecystectomy and the rest 3 patients had laparoscopic cholecystectomy. Accordingly the rate for open cholecystectomy was 13/588(2.21%), and that of laparoscopic surgery
3/57(5.26%). Twelve (92.3%) of the complicated cases in open cholecystectomy were done by residents alone. The rate of complications for the consultants in open surgery was 0.2% and that of the residents 6.0%. The odd that patients operated by residents will develop IBDI was 6.25 times higher than that of the seniors. There is statistically significant
association between seniority and major surgical complications(X2= 11.91, P=0.001).
Conclusions: The incidence of major complications of cholecystectomy is unacceptably high in this study. Almost all complications occurred in the hands of residents which show that experience matters. Therefore it is our recommendation that residents should not be left alone until they get reasonable experience in the field.
