A five-year review of cholecystectomy in a hepato-pancreatobiliary surgery unit of the University of Calabar teaching hospital, Nigeria

Abstract

The aim of this study was to evaluate the pattern of presentation of patients who had cholecystectomy in a dedicated Hepato-Pancreato-Biliary (HPB) Surgery unit of this facility and the benefit of laparoscopic cholecystectomy over conventional open cholecystectomy. This is a five year retrospective study (June 2009- May 2014) of all patients who had cholecystectomy in the HPB surgery unit of the University of Calabar Teaching Hospital,Calabar, Nigeria. The records of all patients who had cholecystectomy during the study period were retrieved. Relevant information were obtained and analysed using appropriate mathematical tools. A total of 505 surgeries were done in the unit during the period under review out of which 190 (37.6%) were major cases and 44(8.7%) were core HPB cases . A total of fifteen (15) patients (3% of all surgeries in the unit) had cholecystectomy during the study period. All had features of acute cholecystitis. There were 12 females and 3 males, giving a female to male ratio of 4:1. The mean age was 43.1years with a range of 27-62 years. Thirteen (86.7%) of these patients had open cholecystectomy while only two (12.3%) had laparoscopic cholecystectomy. Only one patient (6.7%) had cholesterol stones while the rest had pigmented gall stones. Fever was not a major mode of presentation (87%). Diagnosis was made using a combination of clinical assessment and imaging.The average duration of hospital stay after open cholecystectomy was 7 days as against 2 days for those who had laparoscopic cholecystectomy. The prevalence of symptomatic gallstone disease is still low in our environment compared to the Western World and is commoner in females than males. Laparoscopic surgery has very good prospects in our environment.

Keywords: Cholecystectomy, Dedicated HPB surgery unit, Early experience with laparoscopic surgery