Laparoscopic Cholecystectomy in Mauritania About 742 cases

Ahmedou Moulaye IDRISS. National Hospital Center

Introduction: Biliary lithiasis is known to be rare in Africa. In Mauritania the frequency of this pathology is related to some traditional customs such as gavage. The authors report a retrospective descriptive study of 742 patients with gallstones. The aim of the study is to assess the care and the profile of gallstones in general surgery department at the Sheikh Zayed hospital in Nouakchott (Mauritania) on 12 years, period from September 2001 to September 2013.
Patients and Methods: Over a period of 12 years 742 files were included. Databases were statistically analyzed by SPSS and the variables studied were: age, gender, ethnicity, previous history, clinical biology, US and Scanner, type of intervention, route first, and postoperative length of stay .

Results : There were operated 742 patients for gallbladder disease between September 2001 to September 2013, including 553 women and 189 men, sex ratio 2.9. The average age was 48.8years, with a range of 16-76 years. 112 patients had a medical history is 15.09%. All patients were symptomatic and had an ultrasound in less than 3 weeks before surgery. The final diagnosis was 532 single vesicular lithiasis, acute cholecystitis 206 and 4 gallbladder polyps . The intervention was initially carried out by three trocars, trocar was a 4th placed 68 times the demand. The procedure was converted to conventional route 98 times or 13.2 %. This conversion was present especially at the beginning of our experience. The dissection was the same as in conventional route, dissection of Calot's triangle the cystic duct was cut between two ligatures clips. Cholecystectomy was considered laborious 208 times, 314 times simpler and unspecified 122 times . 8 patients had a rebound in 24 or 48 hours. It deplored 4 deaths . The immediate postoperative course was uneventful in 636 cases out of 41 infections wall on the outlet of the gallbladder quickly curbed by local care and antibiotics. Distant suites: lost 477 seen after 1 month, 2 patients were operated to 7 years for hernia on the outlet of the bladder. 37 patients were seen in the long term, 6 of these patients had small hernias on the outlet of the gallbladder, 2 of which were made ??at 5 years and 7 years.

Conclusion: Cholelithiasis is common Mauritania, its early care is needed to avoid the occurrence of complications and reduce the percentage of deaths . And its management laparoscopic load still requires awareness of surgeons and patients because it is feasible in our context but human resourse and matriels are limited.

Keywords: biliary lithiasis, cholecystitis, Laparoscopy, Ultrasound.

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