A Decade of Cholecystectomy at Kenyatta National Hospital: Demographics, Patterns and Transition to Laparoscopy
Jani PG1, Gill H2
1. School of Medicine, University of Nairobi
2. Department of Surgery, Groote Schuur Hospital, Cape Town, South Africa.
Correspondence to: Prof. Pankaj Jani P.O Box 45640 -00100 Nairobi. Email: pjani53@gmail.com
 
Abstract
Background: In the early 90’s all cholecystectomies at the Kenyatta National Hospital were open cholecystectomies. Currently only third undergo the open operation. We conducted a study to analyze the age and sex, mode of presentation, investigations done and operation performed, in view of the changing mode of treatment from open to laparoscopic cholecystectomy (LC). Methods: A Retrospective descriptive study over 10 years from 2001 to 2010. Results: 207 patient files could be traced of whom 80% were females and 40% were under 40years. Almost all patients presented with RUQ pain with about half having a positive Murphy’s sign. Abdominal Ultrasound (USs) was available to most patients and with good reporting. However pertinent laboratory investigations especially liver function tests were not done in over half the patients. LC was offered to about 67% of the patients with a conversion rate of 5%. Conclusion: Kenyatta National Hospital must strive to increase laparoscopic procedures. There is also need to improve the pre-operative laboratory investigations in patients with gallstones.
Key Words: Cholecystectomy, Transition, Laparoscopy, Developing country
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