Laparoscopic management of gall bladder diseases in Nigeria: A systematic review
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Keywords
Nigeria, Gallbladder disease, Cholelithiasis, Cholecystitis, Cholecystectomy, Laparoscopic, Minimal access surgery
Abstract
Background: Globally, the incidence and mortality from gallbladder diseases is on the rise. The gold standard for the management of symptomatic gallbladder disease is laparoscopic cholecystectomy. The practice of laparoscopic cholecystectomy is at a nascent stage in Low and middle-income countries like Nigeria despite its obvious advantages over traditional open cholecystectomy. This systematic review aims to assess the extent to which laparoscopic cholecystectomy is performed for the management of gallbladder diseases in Nigeria.
Methodology: The review was guided by the PRISMA model. We searched MEDLINE, Embase, CINAHL, Scopus, and Global health databases. All searches were conducted in August 2023. All study designs reporting laparoscopic cholecystectomy in Nigeria, in the past 10 years were included. Three authors conducted the data extraction using data extraction tables and two authors independently assessed the data for accuracy and completeness. The Joanna Briggs Institute critical appraisal tool was used to assess the data quality. Twenty-two articles with 1569 patients were included in this review.
Results: Females accounted for 69.5% of the patients and 30.5% were males. Twelve (54.5%) of the studies were from the Southwest of the country, 3 (13.6%) each from the South East and North Central regions, 2 (9.1%) South-South, and 1 (4.5%) each from the North East and North West. Study designs were mostly cross-sectional with sample sizes from 1 to 400. The highest and lowest number of laparoscopic cholecystectomies reported were 300 and 1 respectively. The majority (95.2%) of laparoscopic cholecystectomies were on account of calculous cholecystitis and the methods reported were the 4-port and 3-port techniques. The follow-up period ranged from 3 weeks to 2 years with 54 (3.4%) complications reported.
Conclusions: Laparoscopic cholecystectomy in Nigeria is relatively safe with minimal complications. Its demand and uptake are on the rise, though slowly owing to its relatively high cost.
References
2. Liu S, Yi M, Qin J, Lei F, Lin L, Li Y, et al. The increasing incidence and high body mass index-related burden of the gallbladder and biliary diseases–A results from the global burden of disease study 2019. Front Med (Lausanne). 2022 Dec 2;9.
3. Yuksekdag S, Bas G, Okan I, Karakelleoglu A, Alimoglu O, Akcakaya A, et al. Timing of laparoscopic cholecystectomy in acute cholecystitis. Niger J Clin Pract. 2021 Feb 1;24(2):156–60.
4. Gallstones (Cholelithiasis): Practice Essentials, Background, Pathophysiology [Internet]. [cited 2023 Nov 13]. Available from: https://emedicine.medscape.com/article/175667-overview#a2
5. Rustagi T, Dasanu CA. Risk factors for gallbladder cancer and cholangiocarcinoma: Similarities, differences, and updates. Vol. 43, Journal of Gastrointestinal Cancer. 2012. p. 137–47.
6. Ibitoye BO, Adisa AO, Makinde ON, Ijarotimi AO. Prevalence and complications of gallstone disease among pregnant women in a Nigerian hospital. International Journal of Gynecology& Obstetrics. 2014 Apr;125(1):41–3.
7. Taki-Eldin A, Badawy AE. Outcome of laparoscopic cholecystectomy in patients with gallstone disease at a secondary level care hospital. Arq Bras Cir Dig. 2018 Jun 21;31(1): e1347.
8. Bashir SI, Adam RB, Owish KA, Abdalla AM, Abdullah AM, Ali YB. Mini-laparotomy for cholecystectomy in resourced limited settings: a 10-year retrospective hospital-based study. PAMJ 2022; 42:304. 2022 Aug 23;42(304).
9. Smiley KE, Wuraola F, Mojibola BO, Aderounmu A, Price RR, Adisa AO. An Outcomes-Focused Analysis of Laparoscopic and Open Surgery in a Nigerian Hospital. Journal of the Society of Laparoendoscopic Surgeons. 2023 Jan 1;27(1).
10. Mba EL, Mshelia NM, Obiano SK. Is laparoscopic cholecystectomy safe in Gombe, Nigeria? World Journal of Laparoscopic Surgery. 2018 Sep 1;11(3):132–4.
11. PRISMA. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) [Internet]. 2023 [cited 2023 Oct 18]. Available from: http://www.prisma-statement.org/
12. Joanna Briggs Institute. JBI Critical Appraisal Tools [Internet]. Global. 2023 [cited 2023 Oct 18]. Available from: https://jbi.global/critical-appraisal-tools
13. Adisa AO, Lawal OO, Adejuyigbe O. Trend Over Time for Cholecystectomy following the Introduction of Laparoscopy in a Nigerian Tertiary Hospital. Nigerian Journal of Surgery. 2017;23(2):102–5.
14. Adisa A, Olasehinde O, Alatise O, Ibitoye B, Faponle A, Lawal O. Conversion, and complications of elective laparoscopic cholecystectomy in a West African population. The Egyptian Journal of Surgery. 2018;37(4):440.
15. Olajide T, Osinowo A, Balogun O, Afolayan M, Bode C, Atoyebi O. Experience with laparoscopic cholecystectomy in a tertiary hospital in Lagos, Nigeria. Journal of Clinical Sciences. 2020;17(1):1.
16. Adedayo AA, Onigbinde OM, Oguntola AS, Idowu AN. Maiden Paediatric Laparoscopic Cholecystectomy in a Nigerian Hospital-a Worthwhile Adventure Case Report. Integrated Journal of Medicine and Medical Science. 2021;7(3):137–70.
17. Ayandipo OO, Afuwape OO, Olonisakin R P. Laparoscopic cholecystectomy in Ibadan, Southwest Nigeria. Journal of West African College of Surgeons. 2013;3(2):15–26.
18. Adisa AO, Lawal OO, Arowolo OA, Alatise OI. Local adaptations aid the establishment of laparoscopic surgery in a semi-urban Nigerian hospital. SurgEndosc. 2013 Feb 1;27(2):390–3.
19. Balogun OS, Osinowo AO, Olajide TO, Lawal AO, Adesanya AA, Atoyebi OA, et al. Development and practice of laparoscopic surgery in a Nigerian tertiary hospital. Niger J Clin Pract. 2020 Oct 1;23(10):1368–74.
20. Adenekan AT, Aderounmu AA, Wuraola FO, Owojuyigbe AM, Adetoye AO, Nepogodiev D, et al. Feasibility study for a randomized clinical trial of bupivacaine, lidocaine with adrenaline, or placebo wound infiltration to reduce postoperative pain after laparoscopic cholecystectomy. BJS Open. 2019 Aug 1;3(4):453–60.
21. Adisa AO, Adedeji TA, Bolarinwa RA, Owojuyigbe TO, Jeje OA, Glasbey J, et al. The inflammatory response to surgery in sickle cell disease patients undergoing cholecystectomy. Journal of the Society of Laparoendoscopic Surgeons. 2019 Apr 1;23(2).
22. Afuwape OO, Ayandipo OO. Knowledge and Perception of Laparoscopic Surgery among Surgical Outpatients in a Nigerian Teaching Hospital. Med J Zambia. 2017;44(4):276–81.
23. Obonna GC, Obonna MC, Mishra RK. Laparoscopic subtotal cholecystectomy: Our experience. World Journal of Laparoscopic Surgery. 2021 May 1;14(2):95–7.
24. Ekwunife CN, Njike CI. Intent at day case laparoscopic cholecystectomy in Owerri, Nigeria: initial experiences. Niger J Surg. 2013;19(1):16–9.
25. Aghahowa ME, Salu IK, Nwokorie RM, Bassey OS, Esomonu SN, Gali MB. The Trend of Cholecystectomies After the Introduction of Laparoscopic Surgery in a District Hospital in Abuja, North Central Nigeria. Cureus. 2023 Jun 29;
26. Ekwunife CN, Nwobe O. First 100 laparoscopic surgeries in a predominantly rural Nigerian population: a template for future growth. World J Surg. 2014 Jan 1;38(11):2813–7.
27. Ekwunife C, Emegoakor C, Anyanwu S, Chianakwana G. Pioneering laparoscopic surgery in South-eastern Nigeria: A two-center general surgery experience. Nigerian Journal of Basic and Clinical Sciences. 2012;9(2):75.
28. Ismaila BO, Samaila SI, Ale AA. Laparoscopic surgery in a Nigerian Teaching Hospital for 1 year: Challenges and effect on outcomes. Nigeria Journal of Medicine. 2013;22(2):134–7.
29. Igwe PO. Minimal Access Surgical Experience in Developing Economy: A Young Trainee Stimulant. World Journal of Laparoscopic Surgery. 2021;14(1):20–2.
30. Igwe PO, Diri ON. Laparoscopic cholecystectomy for giant gallstone: Report of two cases. Int J Surg Case Rep. 2020 Jan 1; 67:207–10.
31. Mba EL, Mshelia NM, Obiano SK. Is laparoscopic cholecystectomy safe in Gombe, Nigeria? World Journal of Laparoscopic Surgery. 2018 Sep 1;11(3):132–4.
32. Sheshe A, Tsauni I, Yakubu A, Alhassan S. Early experience with laparoscopic surgical operations in Aminu Kano Teaching Hospital, Kano, Northwestern Nigeria. Archives of International Surgery. 2014;4(1):1.
33. Aghahowa ME, Salu IK, Esomonu SN, Umar MU, Bello O, BM GBM. Laparoscopic General Surgeries in a Developing Country: A 5-Year Private Hospital Experience in Abuja, Federal Capital Territory, Nigeria. Borno Medical Journal. 2022 Dec 31;19(2):1–8.
34. Mattson A, Sinha A, Njere I, Borkar N, Sinha CK. Laparoscopic cholecystectomy in children: A systematic review and meta-analysis. The Surgeon. 2023 Jun 1;21(3): e133–41.
35. Kapoor VK, Anand BS. Acute Cholecystitis [Internet]. 2022 [cited 2023 Oct 18]. Available from: https://emedicine.medscape.com/article/171886-overview#a1
36. Degu S, Kejela S, Zeleke HT. Perioperative mortality of emergency and elective surgical patients in a low-income country: a single institution experience. Perioperative Medicine 2023 12:1. 2023 Sep 16;12(1):1–8.
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