ADMISSION PATTERN, CLINICAL PROFILE AND TREATMENT OUTCOME OF BILIARY STONE DISEASE AT SAINT PAUL’S HOSPITAL, ADDIS ABEBA ETHIOPIA: A TWO YEARS RETROSPECTIVE REVIEW STUDY

Abstract

Abstract Background: More than 95% of biliary tract affections are due to gallstone disease. Open cholecystectomy used to be the standard procedure for treatment of cholelithiasis until the introduction of laparoscopic cholecystectomy which is now the gold standard for treating gall stone disease in the developed world. Nevertheless, open Cholecystectomy is still widely practiced in the developing world [4]. Mortality rates, Morbidity rate and length of hospital stay were all significantly associated with age, admission pattern, and disease status [16]. Objectives: To determine the admission pattern, clinical profiles and treatment outcomes of biliary stone disease at SPHMMC Addis Ababa, Ethiopia. Methods: A retrospective review of patient chart and operation logbook was done in the period of January 2015 to December 2017 in St paul’s hospital, Addis Ababa, Ethiopia. Data was analyzed by SPSS statistical software. Pearson’s chi-square test was used for statistical analysis. P-value <0.05 was considered significant Result: A total of 316 patients were included in the study. 266 (84.2%) were female and 50 (15.8%) were male with female to male ratio of 5:1. The mean age of diagnosis is 41.19 years. Elective and emergency admissions is 301 (95.3%) and 50 (4.7%) respectively.The commonest admission diagnosis is Symptomatic Cholelithiasis 232 (73.4%) followed by CBD stone 38 (12.0%), Resolving Cholecystitis 24 (7.6%), Resolving Cholangitis 11(3.5%), Chronic Cholecystitis 5 (1.6%), Asymptomatic Cholelithiasis 3 (0.9%), Gangrenous/Perforated GB 3 (0.9%). The overall Morbidity rate and the incidence rate of bile duct injuries were 11 (3.5%), and 5 (1.6%) respectively. The overall Mortality rate was 3 (0.9%). Conclusion: Open cholecystectomy and CBD expoloration with choledeochodoudenostomy are the two most commonly done procedure for management for biliary stone disease with slightly higher rate of morbididty and mortality rate.There is higher incidence rate of bile duct injury. Morbidity rate has clinicaly significant association with age, admission diagnosis and the type of procedure done. Residents skills and experience should be given emphasis as the higher rate of Bile duct injury occurred in the hand of the residents. Key words: Biliary stone disease, Open cholecystectomy, Laparoscopic cholecystectomy, CBD Exploration