Treatment Of Gallstones With Acute Cholecystitis At The National Hospital In The Capital Of The Republic Of Somalia

[Objective] Through the investigation and comparison of the treatment strategies and current situation of cholecystolithiasis with acute cholecystitis between the National Hospital of the Republic of Somalia and a third-class hospital in Zhejiang Province of China,the rationality,economy and standardization of the treatment strategies were analyzed,so as to further improve the diagnosis and treatment level and be more in line with the national conditions of the Republic of Somalia.[Materials and methods] The general data of patients in two hospitals,including treatment methods,postoperative complications,hospital stay and treatment costs,operation methods and time,and the interval time between symptom onset and surgical treatment,were collected and compared by variance analysis.【 Results 】 Among the 79 cases of gallstones with cholecystitis in Kalkal Hospital in Mogadishu,Somalia,53 cases(67.9%)were female and 16 cases(32.0%)were male.Among 399 cases in S Hospital in China,229(57.4%)were female and 170(42.6%)were male.The peak age of onset was 41-50 years(42%)at Kalkal Hospital in Mogadishu,Somalia,and 51-60 years(25.7%)at S Hospital in China.The time interval between the onset of acute cholecystitis with gallstones and surgical intervention between Kalkal Hospital and S Hospital in China was less than 24 h,only 2 cases were reported in Kal Kal Hospital and 63 cases in S Hospital in China,and only 6 cases were reported in Kal Kal Hospital and 132 cases were reported in S Hospital in China during 24-48 h.The length of postoperative stay in Kalkal Hospital was 5-7 days,42 cases(84.0%);6 patients were discharged 5 days after surgery(5-6 days).2 cases(more than 7 days)were hospitalized.The length of postoperative stay in S Hospital in China was 5-7 days,1028(64.4%);380patients were discharged 5 days after surgery(5-6 days).569 cases(more than 7 days)were hospitalized.In the case of Kalkal Hospital in Mogadishu,Somalia,the highest surgical costs were >$400,while the majority of the 22 surgeries were under $200.In China S Hospital,the highest surgical cost is more than $400,while most of the 1303 surgical costs are between $200 and $300.The number of cholecystectomy cases was 1 in Kalkal Hospital and 6 in S Hospital.[Conclusion] For cholecystolithiasis with acute cholecystitis,most grade I patients have a good prognosis,Grade II patients need timely surgical treatment,and Grade III patients,who cannot tolerate surgery and need intervention,usually adopt PTGBD,which can relieve symptoms and lay a foundation for later surgical resection.At the same time,the time for patients to see a doctor in Somali hospitals is late,and the surgical techniques need to be further improved.It is necessary to strengthen the education of Somali people,improve the awareness of early treatment of Somali people,and further change the treatment concept of doctors.