Prevalence and Factors Associated with Surgical Site Infection in Patients Undergoing Hepato-Pancreaticobiliary Surgery: A Crossectional Multicentric Study, Addis Ababa
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Date
2025-07
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Addis Ababa University
Abstract
Background: Acute cholangitis (AC) is a life threatening infection of the biliary system, most commonly caused by choledocholithiasis or malignant biliary obstruction. Despite advances in diagnostics and treatment, its burden in low resource settings remains under characterized.
Objective :This study aimed to evaluate the clinical profile, etiological factors, management practices, and outcomes of patients diagnosed with acute cholangitis over a five year period at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods :A retrospective hospital based study was conducted involving 81 patients admitted with acute cholangitis from January 2020 to December 2024. Data were collected from medical records using a structured form and analyzed using SPSS version 25. Logistic and linear regression were performed to identify predictors of adverse outcomes and severity grading.
Results :The mean age of patients was 53.96 years; 56.8% were female. Choledocholithiasis and malignant obstruction were the most common etiologies of acute cholangitis attributing for 50.6% and 40.7% respectively. Jaundice (95.1%) and RUQ abdominal pain (71.6%) were the most frequent presenting symptoms. Only 18.5% fulfilled Charcot’s triad. About 71.6% of patients had definite acute cholangitis while 28.4% had suspected acute cholangitis based on Tokyo Guidelines (TG13. About 85.2% of cases were successfully treated with medical management alone. About 39.5% of patients had unfavorable outcomes. Multivariate analysis identified age AOR : 4.7, 95% CI : 1.04, 21.47; p=0.04 44), presence of morbidity (AOR: 4.7, 95% CI: 1.05, 21.55; p=0.043), TG13 Grade III (AOR:3.1, 95% CI: 2.11, 8.36; p=0.024) to be significantly associated with unfavorable outcome.
Conclusion :This study of acute cholangitis reveals a patient population with distinct demographic and etiological features, including a majority of female patients and a high rate of malignant obstruction (40.7%). The diagnostic utility of Charcot's triad was low (18.5%), while the Tokyo Guidelines (TG13) provided a definitive diagnosis in the majority of cases (71.6%). Current management, favoring open surgery (92.6%), is associated with negative outcomes, including prolonged hospital stays and high complication rates. These findings suggest that a shift toward minimally invasive techniques and adherence to the TG13 diagnostic criteria are necessary to improve patient outcomes.
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Ethiopia, clinical profile, management