Clinical presentation of complicated gallbladder disease in HIV positive patients at Chris Hani Hospital Baragwanath Academic

Palweni, Sechaba Thabo
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Abstract Background: Symptomatic gallbladder disease is a common surgical condition that requires admission and surgical intervention. In South Africa it is estimated that 7.06 million people are living with HIV/AIDS and it is probable that some of these patients have symptomatic gallbladder disease. Aim: To explore the demographics, clinical course and progression of symptomatic gallbladder disease in HIV/AIDS patients at Chris Hani Baragwanath Academic Hospital (CHBAH). Methods: A retrospective analysis of prospectively collected data of patients with confirmed symptoms and signs of symptomatic gallbladder disease namely acute cholecystitis. Patients over 18 years who consent to an HIV test, with the established clinical problem of acute cholecystitis were recruited from the surgical admission wards at CHBAH. Patients with choledocholithiasis, biliary pancreatitis and malignancy were excluded. Demographic data was recorded and the progression of the disease tracked. Patients were recruited over a period between 2013 and 2016, a total of 79 patients were enrolled but only 34 patients were eligible for analysis. The data was analysed with Strata using descriptive statistics. Results: The age of presentation for symptomatic gallbladder disease was between 30-50 years. 8 of these patients were HIV positive. The treatment received in the cohort was both open cholecystectomy (n=2 HIV negative vs. n=1 HIV positive) and laparoscopic cholecystectomy (n=14 HIV negative vs. n=2 in HIV positive). 1 patient who was HIV positive had acute suppurative cholecystitis. 2 of the patients had postoperative complications. None of the variables used to predict complication of symptomatic gallbladder disease examined in this study were found to be statistically significant. Conclusion: This study did not conclusively show that patients with HIV/AIDS and symptomatic gallbladder disease have higher rates of postoperative complications. This supports the literature, which suggests that the HIV status of patients should not preclude surgery
A research report submitted to the faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Masters of Medicine in the branch of General Surgery, 2020