A Review on Prevalence and Risk Factors of Gallstone Disease in Uganda | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 4

Introduction: Globally, the burden and complications from gallstone disease are a major public health issue. It contributes significantly to health care costs and is a common cause of surgical intervention. Most sickle cell disease (SCD) patients have radiolucent stones, probably of pigment type, containing little or no calcium. While most patients with gallstones are asymptomatic, only 20% after 10 years become symptomatic. The prevalence of gallstone disease varies among different populations. The purpose of this review is to understand the profile of gallstone disease patients in Uganda which may facilitate better treatment options and may reduce the complications of gallstone disease.

Discussion: In Uganda, the prevalence of gallstone disease is high in patients presenting to hospital. The risk factors for gallstone disease include a previous history of biliary symptoms and the use of hormonal contraceptives. SCD in Sub-Saharan Africa is also a major health problem and a risk factor for gallstone disease. Acute abdominal pain in SCD patients was thought to be due to sickle cell crises until the advent of ultrasonography. Differentiating between acute cholecystitis and sickle cell crises may be difficult. An increased production of unconjugated bilirubin from a sickle cell crisis may precipitate acute cholecystitis. While in SCD patients with acute cholecystitis, a haemolytic crisis may occur.

Conclusions: While the prevalence of gallstone disease in Uganda from hospital-based studies is high the majority of patients are symptomatic at presentation. In the general population, the prevalence of gallstones may be determined using abdominal ultrasound as a screening tool. Any SCD patient who has an abdominal crisis should have an abdominal ultrasound to prevent missing any episodes of acute cholecystitis.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13177

Potential Port Site Consequences in Laparoscopic Cholecystectomy Using an Open versus Closed Approach of Pneumoperitoneum: A Comparative Study | Chapter 6 | Perspective of Recent Advances in Medical Research Vol. 11

 The standard pattern for cholecystectomy is laparoscopic surgery, and pneumoperitoneum maybe performed in either a closed or open method. However, exposure to the traffic's consequences may improve the patient's morbidity. As a result, this study was completed activity to compare two together approaches in terms of complications at the traffic site of each process and potential risk factors.A potential study was carried out in the department of medical procedure, in hospitals owned by Kirkuk and Diyala governorates in Iraq, from January 2019 to March 2022. The 200 patients who accepted part in the study were divided into two groups, each accompanying 100 patients. The two processes were compared for intraoperative and postoperative questions that could have stood from port insert up to 18 weeks.The findings demonstrated that the highest allotment was for the following: females (84.0%), ages between 50 and 59 age (43.5%), and body bulk index (BMI) range 25-30 kg/m2 (49.0%). No significant distinctness was observed between those variables for two together surgical techniques (p-worth > 0.05). No death was recorded in the study. The following snags were observed at the traffic site in 10.5% of victims, with the majority stated in the open approach (8.5%): draining (3.0%), hematoma (2.0%), wound infection (1.5%), break (1.5%), and vascular injury (0.5%).Thus, we concluded that traffic site problems are lowest in closed laparoscopic abscission which was not proved to be statistically important but values showed less obstacles. Furthermore, samples could be used to gain a good mathematical significance.

Author(s) Details:

Awni Ismail Sultan,
Department of Surgery, College of Medicine, Tikrit University, Iraq.

Sami Hassoon Ali,
Department of Surgery, Jalawla General Hospital, Iraq.

Ozdan Akram Ghareeb,
Department of Community Health, Northern Technical University, Kirkuk, Iraq.

Please see the link here: https://stm.bookpi.org/PRAMR-V11/article/view/9513

Management of Symptomatic Gall Stones in a Tertiary Care Health Facility in Southern Nigeria: A Recent Study | Chapter 9 | Highlights on Medicine and Medical Research Vol. 7

 Background: Gallstone disease is one of the most frequent digestive system diseases. The illness spans from silent to symptomatic stones, each with its own set of problems. The disease is exceedingly uncommon among black people, and it is unknown among Africa's Bantu and Masai tribes. Surgery is still the most effective treatment for symptomatic gallstone disease, as other options are usually ineffective. Previously, open surgery was the only choice for cholecystectomy, but with the development of minimally invasive procedures, laparoscopic cholecystectomy has become the gold standard of surgical care.

Although not widespread in this environment, there is a need to assess the age and sex prevalence, the types of stones that are common, the various modes of clinical presentation and disease spectrum, as well as the treatment modalities used in this institution.

Methods: This is a sixteen-year retrospective review of all cases handled in this institution. Using a proforma, the case files of these patients were downloaded and essential information collected. SPSS VERSION 22 was used to analyse the data.

Results: Gall stone illness is more common in women, with a male-to-female ratio of 1:5.6. The most prevalent age group was 41-50 years, and the most common manner of presentation was recurring right hypochondrial/epigastric discomfort. In contrast to what happens in Europe and North America, the most common stone type was mixed.

Conclusion: This study found that gall stone disease is mainly prevalent among females in this area, and that open surgery is still used to treat it.

Author(s) Details

Promise N. Wichendu
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

A. Dodiyi-Manuel
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

Kelechi Ikonwa
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

View Book :- https://stm.bookpi.org/HMMR-V7/article/view/1064

An Audit of Laparoscopic Surgery in a Developing Country in East Africa at the Beginning of a Surgeon's Learning Curve | Chapter 16 | Highlights on Medicine and Medical Research Vol. 5

 Background: Laparoscopic surgery has been used for surgical access in a variety of situations. The gold standard treatment for cholecystitis in the West is laparoscopic cholecystectomy. Laparoscopic appendicectomy, on the other hand, has sparked debate due to its high cost and time-consuming existence, as well as the numerous trocar sites, which all add up to the duration of an open appendicectomy incision.Laparoscopic surgery has many benefits, including a faster return to daily life, a shorter hospital stay, and less postoperative analgesia. The aim of this study is to evaluate the initial experience of laparoscopic units in a developing country in East Africa.

The thesis was performed retrospectively in the Department of Surgery. This research included all patients who agreed to laparoscopic cholecystectomy and laparoscopic appendicectomy within the first 13 months.

Ten (10) patients consented to laparoscopic cholecystectomies with a male:female ratio of 1:2.33, and twenty (20) patients consented to laparoscopic appendicectomies with a male:female ratio of 1:1.2. The average operating time for laparoscopic cholecystectomy was 58.5 minutes and for laparoscopic appendicectomy was 40.45 minutes. For laparoscopic cholecystectomy, post-operative admission lasted 3 to 5 days, with a mean of 4.2 days, and for laparoscopic appendicectomy, it lasted 2 to 5 days, with a mean of 2.65 days. Aside from a spinal headache in two patients (2.6 percent) out of the total laparoscopic procedures, no other complications were identified. During the one-month follow-up period, there were no readmissions.

Conclusions: Laparoscopic cholecystectomy and appendicectomy are safe and allow for early discharge. The low incidence of cholecystitis in Uganda, relative to the higher incidence of appendicitis, supports the use of laparoscopic appendicectomy for hand and eye coordination training rather than cholecystectomy. The surgeons' initial cases of laparoscopic procedures have shown an acceptable degree of protection, indicating that laparoscopic appendicectomy is a viable option for learning the fundamentals of laparoscopic surgery.

Author (s) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

View Book :- https://stm.bookpi.org/HMMR-V5/article/view/703