Laparoscopic cholecystectomy at the Nairobi Hospital: a personal experience with 42 cases.

BACKGROUND

Laparoscopic cholecystectomy is a recent entry in the treatment of gall bladder disease in Kenya and is slowly gaining acceptance. Like all new techniques, it has generated considerable controversy and debate on its merits over the traditional open operation.

OBJECTIVE

To report a personal series of laparoscopic cholescystectomy operations, to determine the safety, effectiveness and acceptability of the method in a private hospital setting in Kenya and in general if this surgery should be promoted in this country.

DESIGN

Retrospective case study of personal series of laparoscopic cholecystectomy over a period of two years.

SETTING

The Nairobi Hospital.

RESULTS

Forty two patients underwent the operation, five males and 37 females. There were three conversions to open cholecystectomy for various reasons, but the rest did well and results were favourable.

CONCLUSIONS

Although initial capital investment in laparoscopic equipment is high and although there is a learning curve for surgeons which discourages some, the method offers advantages which cannot be ignored. It is safe and gives patients great satisfaction. There is less pain than in the traditional open method, and patients have a shorter hospital stay and early return to work. Where facilities permit it should be practiced; future effort should be directed at making it safer and more widely accepted by training users.