Emergency surgery for gallbladder and biliary tract diseases

ABSTRACT

One hundred and four patients, underwent urgent surgery for acute gallbladder and biliary tract diseases. Sixty-eight of the patients were females and thirty-six males the female to male ratio of 1.81. the mean age of the female to male patients was 52 years and 55 years respectively. The clinical presentation laboratory ultrasound, computed tomogram and ERCP had a very good rule in the diagnosis. Urgent surgical interference was done for all patients within 5-38 h [mean of 6 +/- 4 h] of hospitalization. The studied cases were divided into four groups according to the indications and the surgical preocedures. The first group of 46 patients [44 per cent] underwent urgent cholecystectomy. The second group of 22 patients [21 per cent], cholecystectomy combined with choledochotomy. The third group of 19 patients [18 per cent] underwent cholecystostomy. The fourth group of 17 patients [16 per cent] for urgent biliary enteric anastomosis. Four pregnant female patients, were included in first group. Postoperative complications were encountered in 17 patients [16 percent]. There were 5 deaths, a mortality of 4 percent. It is concluded that urgent gallbladder and biliary tract surgery is indicated in cases of progression of the inflammatory process or inflammatory mass progression of jaundice, acute cholangitis, despite conservative treatment, perforated gallbladder with biliary peritonitis and injury of the common bile duct during ERCP