A retrospective analysis of operative outcomes of symptomatic biliary stone disease at 2 referral hospitals in Addis Ababa, Ethiopia

Abstract

Background

Gallstone disease (also known as cholelithiasis) is a significant health problem in high-income countries, and while it is thought to be uncommon in Africa, cholelithiasis is currently diagnosed significantly more frequently than would be expected from previous studies. We assessed the magnitude of this disease and its associated surgical outcomes in Addis Ababa, Ethiopia.

Methods

We retrospectively analysed the medical records of patients encountered from 1 January 2015 through 31 December 2017 at the general surgery units of Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital—both in Addis Ababa. All necessary data from the patients’ charts were collected and collated via a pretested structured data collection form. Data were analysed using SPSS Statistics for Windows, version 20.

Results

Our analysis included 317 patients. Nearly half (49.4%) were between 36 and 55 years of age. The chief complaint of most patients (92.1%) was right upper quadrant abdominal pain. Open cholecystectomy and/or biliary surgery was performed on 298 patients (94.0%), while the other patients underwent laparoscopic cholecystectomies. Thirty-four per cent of the patients presented with at least 1 comorbidity, including hypertension (n=46, 14.5%) or HIV infection (n=33, 10.4%). Postoperative complications were re­ported in 10.4% of patients; these included wound infection (n=23, 7.3%), pneumonia (n=8, 2.5%) and biliary leakage (n=3, 0.9%). No deaths were reported.

Conclusions

Open surgery remains the commonest procedure used to treat symptomatic cholelithiasis at these 2 centres. In the absence of routine laparoscopic services, open cholelithiasis surgery is a safe and effective treatment option.