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5 year review of surgically managed calculous biliary tract diseases in Cebu Doctors Hospital Patricio H. Moscoso

By: Subject(s): Abstract: Biliary tract operations are still most frequent operation performed in advanced medical centers. All operations for calculous biliary tract diseases in the last 5 years were reviewed at the Cebu Doctors Hospital. The purpose of this review is to describe the profile of the surgically managed calculous biliary tract cases. A total of 157 patients underwent 174 operations and majority of these cases were females (61.7%) and males were (38.2%). Common presenting complaint was abdominal pain (90%). Ultrasound was the most reliable of all diagnostic procedures with accuracy rate of (90%). The most common indication for surgery is still chronic cholecystitis with 55.7% of all operations done, followed by chronic cholecystitis with choledocholithiasis, 26.4%. Acute choleclystitis and acute cholecystitis with choledocholithiasis comprised a minority group Cholecystectomy alone was the most frequent operation performed in 102 patients (58.6%), cholecystectomy with CBD exploration was done in 31% of all cases. Thirteen patients underwent CBDE as a primary procedure with biliary-enteric bypass operations and sphincteroplasty done for impacted stones in CBD wa well as retained stones Associated medical illness show cardiovascular in 17% and diabetes mellitus in 14%. Mortality and morbidity were directly related to age. In this study, patients above 50 years of age have higher morbidity and mortality. Infection was the leading cause of morbidity 9.5% and retained stones in 6%. Mortality rate was 1.2% (2 patients in 157 patients) With these data gathered, biliary tract operations are still considered safe and therefore are still the gold standard in the treatment of calculous biliary tract disease.
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Biliary tract operations are still most frequent operation performed in advanced medical centers. All operations for calculous biliary tract diseases in the last 5 years were reviewed at the Cebu Doctors Hospital. The purpose of this review is to describe the profile of the surgically managed calculous biliary tract cases. A total of 157 patients underwent 174 operations and majority of these cases were females (61.7%) and males were (38.2%). Common presenting complaint was abdominal pain (90%). Ultrasound was the most reliable of all diagnostic procedures with accuracy rate of (90%). The most common indication for surgery is still chronic cholecystitis with 55.7% of all operations done, followed by chronic cholecystitis with choledocholithiasis, 26.4%. Acute choleclystitis and acute cholecystitis with choledocholithiasis comprised a minority group
Cholecystectomy alone was the most frequent operation performed in 102 patients (58.6%), cholecystectomy with CBD exploration was done in 31% of all cases. Thirteen patients underwent CBDE as a primary procedure with biliary-enteric bypass operations and sphincteroplasty done for impacted stones in CBD wa well as retained stones
Associated medical illness show cardiovascular in 17% and diabetes mellitus in 14%. Mortality and morbidity were directly related to age. In this study, patients above 50 years of age have higher morbidity and mortality. Infection was the leading cause of morbidity 9.5% and retained stones in 6%. Mortality rate was 1.2% (2 patients in 157 patients)
With these data gathered, biliary tract operations are still considered safe and therefore are still the gold standard in the treatment of calculous biliary tract disease.

Cebu Doctors' Proceedings, 1992 8 (2) pages 59-64

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