Acute Cholecystitis: Management and Prognostic Factors in the General Surgery Department of the Ignace Deen CHU National Hospital in Conakry Cholécystite aigue : prise en charge et facteurs pronostiques au service de chirurgie générale de l’hôpital national Ignace Deen CHU de Conakry

Abstract

Purpose: The aim of this study was to improve the treatment of acute cholecystitis and to analyze its prognostic factors.

Material and methods: this was a 10-year retrospective study covering all cases of acute cholecystitis admitted to the Department of General Surgery, Ignace Deen National Hospital, Conakry. Variables examined included sociodemographic, treatment, and prognostic factors.

Results: there were 132 cases of acute cholecystitis, accounting for 1.50% of abdominal surgical emergencies. The average age of the patients was 41.5 years. The age group between 26 and 50 years was most affected (50.8%). Women accounted for the majority (59.8%), with a sex ratio of 0.67. Housewives were most commonly affected (38.6%). High-fat diet (98.5%), obesity (6.8%), hemolytic disease (1.5%), and multiple births (17.4%) were the most common predisposing factors. All patients presented spontaneous right hypochondrium pain, and positive Murphy's sign. The fever was present in 87.9% of case, and. Ultrasound examination was performed in all patients. Gallbladder congestion was found in 104 patients (78.8%), and chronic gallbladder was found in 21.2%. The post-operative period was favorable in 125 patients (94.7%), with a morbidity rate of 5.3% and a mortality rate of 1.5%. Poor prognostic factors were the time to medical consultation and the presence of comorbidities in elderly patients. Conclusion: Acute cholecystitis is a medical and surgical emergency. Ultrasound diagnosis and early management of acute cholecystitis are key to its successful management.