Laparoscopic Cholecystectomy in Jos: Prospects and Perspectives

Area of Science:

• Surgical Innovation
• Global Health
• Minimally Invasive Surgery

Background:

• Laparoscopic cholecystectomy adoption is rising in low-income countries, including sub-Saharan Africa.
• While not routine, its utilization has grown in public and private hospitals.
• Introduction of laparoscopic services in 2011 at the study hospital prompted this outcome review.

Purpose of the Study:

• To review outcomes of laparoscopic cholecystectomy over a six-year period.
• To assess the feasibility and safety of the procedure in a low-income setting.
• To identify common indications, comorbidities, and complications associated with laparoscopic cholecystectomy.

Main Methods:

• Retrospective study of 87 cholecystectomies performed between 2011 and 2017.
• Analysis of patient demographics, indications, comorbidities, operative times, and outcomes.
• Comparison of laparoscopic, open, and mini-laparotomy approaches.

Main Results:

• 48 laparoscopic cholecystectomies were performed, with a mean patient age of 41.0 years.
• Calculous cholecystitis was the primary indication; hypertension and sickle cell anaemia were common comorbidities.
• Mean operative time was 86.6 minutes, with 3 conversions and 2 intra-operative complications; 52.1% discharged within 24 hours.

Conclusions:

• Laparoscopic cholecystectomy provides advantages such as reduced hospital stay and fewer wound complications.
• The procedure demonstrates a low conversion rate and minimal bile duct injuries in this setting.
• Sickle cell disease patients represent a significant proportion of those undergoing cholecystectomy.