30 day outcomes of 1000 consecutive laparoscopic cholecystectomies across four Cape Metropole hospitals in Cape Town

Kariem, Maahir

30 day outcomes of 1000 consecutive laparoscopic cholecystectomies across four Cape Metropole hospitals in Cape Town

Thesis / Dissertation

2024

Publisher

University of Cape Town

Department

Division of General Surgery

Faculty

Faculty of Health Sciences

Abstract

Background: Laparoscopic Cholecystectomy (LC) is the standard of care for symptomatic gallstone disease. It has a steep learning curve and can associated with significant post operative morbidity and mortality. LC carries a morbidity of 1.6 – 5.3%, mortality of 0.05 – 0.14% and readmission rates of 3.3% (0-11.7%). We aimed to evaluate the 30 day outcomes of LC across four metropole hospitals in the Western Cape (WC) including mortality, length of stay, readmissions and complications according to the Clavien-Dindo Classification system. Methods: A retrospective review of a prospective database was performed. The data collection was collected between September 2019 and July 2022. Relative clinical, operative findings and post operative outcomes were analysed. Results: There were 1000 consecutive LC included in this study. The mean post operative length of stay was 1.92 days. Fifty-one patients developed surgical complications of which the most common surgical complication was a bile leak (n = 14) and intra-abdominal collections (n=11). Seven patients with bile leaks required reintervention. Four (0.4%) bile duct injuries (BDI) were reported in our series. Twenty-five percent of post operative complications were graded Clavien-Dindo IIIa and 28% were graded Clavien-Dindo IIIb. The 30 day readmission rate was 3.8% (n=38). Thirty-five surgical complications were noted of which 22 (62.8%) required reintervention. There were three reported mortalities (0.3%). Conclusion: Laparoscopic Cholecystectomy is considered the standard of treatment for gallstone disease and has potential serious complications. Our outcomes reported in this series is similar to that of other studies.

Keywords

surgery

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