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Published on: March 28, 2025
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Outcomes in laparoscopic cholecystectomy in a resource constrained environment
1Consultant, Addington Hospital. Department Of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|February 28, 2017
Summary
Laparoscopic cholecystectomy outcomes were evaluated in a resource-limited setting. Despite delayed presentations, complication rates for this gallstone surgery were comparable to other studies.
Area of Science:
- Surgery
- Gastroenterology
- Public Health
Background:
- Laparoscopic cholecystectomy (LC) is standard for symptomatic gallstones.
- Early surgery is preferred for acute cholecystitis, but late presentation is common in resource-limited areas.
- Local inflammation increases bile duct injury risk.
Purpose of the Study:
- To assess laparoscopic cholecystectomy outcomes in a resource-constrained environment.
- To analyze the impact of late presentation on surgical results.
Main Methods:
- Retrospective analysis of 167 laparoscopic cholecystectomies (Jan 2010 - June 2011).
- Evaluation of presentation type, comorbidities, surgery timing, and complications.
Main Results:
- Median age 43, 93% female. Presentations included biliary colic (44%), acute pancreatitis (23%), acute cholecystitis (20%), and obstructive jaundice (13%).
- Conversion to open surgery occurred in 5.4%. Overall complications were 16.2%.
- Bile duct injuries (1.2%) and bile leaks (1.8%) were reported. One mortality (0.6%).
Conclusions:
- Most patients underwent delayed laparoscopic cholecystectomy.
- Outcomes and complication rates were similar across different presentations and comparable to other reports.
- This suggests feasibility of LC even with late presentations in resource-limited settings.
