CHOLECYSTECTOMY TRENDS IN SOUTH AFRICA. SHOULD WE BE WORRIED?

BACKGROUND: Gallbladder disease is a common and costly pathology worldwide. The development of gallstone disease varies among population groups around the world. Epidemiological studies from African countries, including South Africa, Nigeria, Kenya and Uganda suggest that the rate of gallbladder disease is low in the African population. Very little has been published in the last 20 years about the status of gallbladder disease in South Africa.

METHOD: 34294 cholecystectomy specimens were obtained from the NHLS (2003-2015) database. Two periods were analysed, period 1 (2003-2009) and period 2 (2009-2015).

RESULTS: In South Africa, the number of cholecystectomies have increased by 37% in period 2. Seven of the eight analysed provinces recorded an increase in the number of cholecystectomies performed. Of these seven, four were a statistically significant increase. The other three provinces also demonstrated an increasing trend but this did not reach statistical significance. The Northern Cape was the only province to record a decline in the number of cholecystectomies.

CONCLUSION: The increasing trend in cholecystectomies is certainly worrying from a cost and burden of gallbladder disease standpoint. This is particularly worrisome as our population has generally been regarded as being at low risk for the development of gallbladder disease. The results suggest a possible change in the disease pattern in South Africa.