Empirical Analysis of Gallstone Disease Presentation, Management, and Outcomes at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria

Gallstone disease and its complications including cholecystitis, choledocholithiasis, and gallstone pancreatitis represent a frequently encountered surgical condition in South East Nigerian tertiary hospitals, yet institution-specific outcomes data from this zone are limited. This study empirically analyses the presentation patterns, management approaches, and surgical outcomes of gallstone disease at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. A retrospective cohort design is applied to surgical and radiology records of patients with confirmed gallstone disease managed between 2018 and 2023. Variables include clinical presentation type, ultrasonographic findings, liver function test results, operative urgency, procedure performed (open versus laparoscopic cholecystectomy), intraoperative findings, bile duct exploration rate, complications, and 30-day outcomes. SPSS is used for analysis, with chi-square and logistic regression applied. Available hepatobiliary surgery literature from South East Nigeria identifies symptomatic cholelithiasis in middle-aged multiparous women as the most common presentation, with conversion to open cholecystectomy occurring in approximately 15 percent of attempted laparoscopic cases due to dense pericholecystic adhesions. The revised Atlanta Classification guides pancreatitis severity assessment. Findings will contribute to the institution's surgical outcomes registry and inform the laparoscopic surgery training programme. Keywords: gallstone disease, cholecystectomy, biliary surgery, Nnewi, South East Nigeria.