Laparoscopic Cholecystectomy in Mali. State of the Art in 2012: 340 Cases

Objective: To review the practice of laparoscopic cholecystectomy in Mali. Methods: It was a retrospective study over a period of 11 years in general and laparoscopic surgery department of CHU POINT G in Bamako, Mali. This study were included all patients diagnosed and operated on by laparoscopic procedure. Results: Three hundred and forty (340) patients who underwent laparoscopic cholecystectomy were recorded in 1345 laparoscopic interventions (25.28% of all laparoscopic operations). Sickle cell defect was found in 78 patients (22.9% of cases). The gallbladder was adherent to adjacent structures in 45.3% of cases. Adhesions were source of operative difficulties in 179 cases (52.6%). Conversion to laparotomy was made in 18 patients (5.3% of cases). The average length of postoperative hospital stay was 2 days. The postoperative course was uneventful for 320 patients (94.11%). The postoperative complications were observed in 20 patients (5.88% of cases: surgical in 2 cases medical, 15 cases (4.4%) in relation with sickle cell disease, four (4) of these patients died (1.2%): pulmonary embolism, gastrointestinal hemorrhage, acute renal failure. No deaths were attributable to the procedure. Conclusion: Laparoscopic cholecystectomy should be the gold standard in developing countries