Clinical presentation of complicated gallbladder disease in HIV positive patients at Chris Hani Hospital Baragwanath Academic
Date
2020
Authors
Palweni, Sechaba Thabo
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Abstract
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
Description
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