title: Outcomes in laparoscopic cholecystectomy in a resource constrained environment.
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) is a common surgical procedure performed for symptomatic gallstones. There is a trend towards early cholecystectomy for patients with acute cholecystitis who present timeously. Local inflammation has been identified as a risk factor for bile duct injuries. This study sought to assess the outcomes of LC in patients managed within a resource constrained environment where late presentation is common.
  
  
  METHODS
  We performed a retrospective analysis of laparoscopic cholecystectomy performed from January 2010 to June 2011. The mode of presentation, co-morbidities, timing of cholecystectomy and complications were analysed.
  
  
  RESULTS
  One hundred and sixty seven patients were evaluated. The median age was 43 years with range (17-78) years and 93% were female and 7% male. There were 44%, 23%, 20% and 13% who presented with biliary colic, acute pancreatitis, acute cholecystitis and obstructive jaundice respectively. Nine (5.4%) patients required conversion to an open cholecystectomy. Complications occurred in 16.2% and bile duct injuries and bile leaks in 1.2% and 1.8% respectively. One patient died.
  
  
  CONCLUSIONS
  Most patients had a delayed laparoscopic cholecystectomy. There was no difference in outcomes for the different presentations and the complications are similar to other reports.
authors.affiliation: Consultant, Addington Hospital. Department Of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Mbatha
authors.affiliation: Head of Department - Specialised Surgery, Inkosi Albert Luthuli Hospital. Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal.
authors.forename: F
authors.initials: F
authors.lastname: Anderson