International Journal of Surgical Research 2015, 4(2): 11-14 DOI: 10.5923/j.surgery.20150402.01 Laparoscopy in Upper Gastro-Intestinal non Tumoral Pathologies: Our Experience in a Low Income Country Toure Alpha O. 1,* , Foba Mamadou Lassana 1 , Ka Ousmane 1 , Cisse Mamadou 1 , Konate Ibrahima 2 , Dieng Madieng 1 , Toure Cheikh T. 1 1 General Surgery Department, Le Dantec Hospital, Avenue Pasteur, Dakar, Senegal 2 Surgery and surgical specialties Department, Gatson Berger University, Saint, Louis, Senegal Abstract The aim of our study was to evaluate the contribution of laparoscopy in non-tumoral Upper GastroIntestinal (UGI) diseases in our working conditions. This was a retrospective descriptive study in General Surgery Department of Le Dantec University Hospital in Dakar on a period of 10 years (January 2003 to January 2013). We included 162 cases patients treated by laparoscopy for acute or chronic UGI disease. The pathologies encountered were hiatal hernia in 18.5% of cases (n = 30); achalasia in 13% of cases (n = 21); ulcerative pyloroduodenal stenosis in 55.5% of cases (n = 90); perforated duodenal ulcer in 13% of cases (n = 21). We performed truncal vagotomy and gastric bypass, Nissen Rossetti fundoplication, Heller Myotomy and ulcer sutures as laparoscopic procedures. The average length of surgery was 84 minutes (22mn - 130mn). Six cases of operating incidents were recorded (1 case of accidental injury of a left hepatic artery and 5 esophagal perforations). Conversion to laparotomy was required in 12 cases (7.4%). The delay of oral feeding varied between 1 and 4 days with an average of 2.5 days. Postoperative courses were uneventful in 152 patients (93.8%). Nine postoperative complications were found: gastroparesis (4 patients), postoperative peritonitis (1 case), and dysphagia (4 patients). A death was noted in 1 case by postoperative peritonitis secondary to sepsis. The mean hospital stay was 7 days with extremes ranging from 3 to 10 days. Keywords Laparoscopy, Hiatal hernia, Duodenal ulcer complications, Achalasia 1. Introduction Laparoscopic surgery implants itself increasingly in the treatment of digestive diseases in our sub-Saharan countries despite our limited means [1]. Thus, after cholecystectomy, indications extend to upper gastro-intestinal (UGI) tract diseases such as progressive complications of duodenal ulcer and certain disorders of the cardia. The aim of our study was to evaluate the contribution of laparoscopy in non-tumoral UGI diseases in our working conditions. 2. Patients and Methods This was a retrospective descriptive study in General Surgery Service of the University Hospital Le Dantec in Dakar on a period of 10 years (January 2003 to January 2013). We included all patients treated by laparoscopy for acute or chronic UGI disease. Thus, we collected 162 cases. Epidemiological data on patients were listed in Table 1. The following data were studied: nature of the * Corresponding author: alpha.oumar@yahoo.fr (Toure Alpha O.) Published online at http://journal.sapub.org/surgery Copyright © 2015 Scientific & Academic Publishing. All Rights Reserved pathologies, laparoscopic procedures, conversion factors, duration of surgery, delay to oral feeding, length of hospital stay, morbidity and mortality. Table 1. Patients’ epidemiological datas Patients Mean age (mini - max) Gender M F Ratio Acute pathologies 34,5 years (20-63 years) 20 1 20 Chronic pathologies 36,8 years (17-82 years) 87 54 1,6 Total 35,7 years (17-82 years) 107 55 1,9 3. Results The pathologies encountered were: - Hiatal hernia with gastroesophageal reflux rebel to medical treatment in 18.5% of cases (n = 30); - Achalasia in 13% of cases (n = 21); - Ulcerative pyloroduodenal stenosis in 55.5% of cases (n = 90); - Perforated duodenal ulcer in 13% of cases (n = 21). All patients with pyloroduodenal stenosis underwent truncal vagotomy performed laparoscopically. Gastric