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Background: Surgical biliary bypass remains an important palliative option for patients with advanced pancreatic cancer in settings where endoscopic biliary drainage and interventional oncology are not consistently available. However, data on postoperative outcomes and survival after biliodigestive bypass in sub-Saharan Africa remain scarce. This study aimed to evaluate surgical procedures, postoperative morbidity, and survival after biliodigestive bypass for pancreatic cancer in two tertiary hospitals in Douala, Cameroon. Methods: We conducted a retrospective bicentric cohort study including patients who underwent surgical biliodigestive bypass for pancreatic cancer at Douala General Hospital and Laquintinie Hospital of Douala between January 2013 and December 2022. Sociodemographic, clinical, biological, radiological, operative, postoperative, and survival data were collected from medical records. Postoperative complications and survival outcomes were analyzed. Overall survival was estimated from the date of surgery to death or last follow-up. Results: Forty patients were included. The mean age was 60.1 ± 12.9 years, and 24 patients (60.0%) were male. All patients presented with stage IV disease. The most frequently performed biliary procedures were choledochoduodenostomy in 18 patients (45.0%) and choledochojejunostomy in 16 patients (40.0%). Gastroenterostomy was associated in all cases. Roux-en-Y double bypass was performed in 17 patients (42.5%), while an omega-loop configuration was used in 2 patients (5.0%). Overall postoperative morbidity within 30 days was 57.5%. The most common complications were surgical site infection in 5 patients (12.5%), biliary fistula in 3 patients (7.5%), and digestive fistula in 3 patients (7.5%). The median overall survival was 2.6 months (78 days). The estimated 1-month and 6-month survival rates were 87.5% and 12.5%, respectively. In multivariable analysis, diabetes mellitus (adjusted HR: 2.65, 95% CI: 1.10–6.38; p = 0.030) an

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Background: Malignant bowel obstruction is a severe complication of advanced intra-abdominal and extra-abdominal cancers. In resource-limited settings, delayed presentation, limited access to endoscopic palliation, and reliance on emergency surgery may worsen outcomes. This study aimed to identify factors associated with mortality among patients managed for malignant bowel obstruction in two tertiary hospitals in Douala, Cameroon. Methods: We conducted a retrospective multicenter analytical study in the visceral surgery departments of Douala General Hospital and Laquintinie Hospital of Douala from January 1, 2019, to December 31, 2024. All patients managed for confirmed malignant bowel obstruction were included. Patients with benign obstruction or unusable medical records were excluded. Sociodemographic, clinical, paraclinical, tumor-related, therapeutic, and outcome variables were analyzed. The primary outcome was postoperative mortality. Logistic regression analysis was used to identify factors associated with mortality, and statistical significance was set at p < 0.05. Results: Among 287 cases of intestinal obstruction, 50 were of malignant origin, corresponding to 17.4% of intestinal obstructions. Malignant bowel obstruction represented 3.7% of acute abdominal emergencies during the study period. The mean age was 53.0 ± 15.0 years, with a male predominance of 68% and a sex ratio of 2.1. The colon was the most frequent tumor site, particularly the rectosigmoid junction. Computed tomography was performed in 64.0% of cases. Laparotomy was performed in 44 patients (88.0%). The most common surgical procedures were resection with stoma formation and resection with anastomosis. The postoperative mortality rate was 22%. Factors associated with mortality included previous abdominal surgery, vomiting, preoperative dehydration, poor performance status, complete bowel obstruction, immediate emergency surgery, and resection with stoma formation.

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Background: Postoperative complications remain a major cause of morbidity and mortality following emergency digestive surgery, particularly in low- and middle-income countries where delayed presentation and limited healthcare resources are common. Evidence regarding predictors of postoperative complications in sub-Saharan Africa remains scarce. This study aimed to determine the incidence, pattern, severity, and predictors of postoperative complications following emergency digestive surgery in three tertiary hospitals in Cameroon. Methods: We conducted a multicenter retrospective analytical study in three referral hospitals in Douala, Cameroon, including the Douala General Hospital, Douala Laquintinie Hospital, and Deido District Hospital. Adult patients undergoing emergency digestive surgery between January 2018 and December 2023 were included. Demographic, clinical, operative, and postoperative data were collected. Complications were graded according to the Clavien–Dindo classification. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of postoperative complications. Results: We analyzed 1,102 patients undergoing emergency digestive surgery, among whom 361 developed postoperative complications (32.8%). Surgical site infection was the most frequent complication (32.6%). Most complications were classified as minor (73%) according to Clavien–Dindo grading. The overall mortality rate was 7.2%. Multivariate analysis identified age between 50 and 60 years, ASA III status, and Altemeier class III as independent predictors of postoperative complications. Conclusion: Approximately one-third of patients undergoing emergency digestive surgery developed postoperative complications. Advanced age, poor preoperative physical status, and contaminated surgical wounds significantly increased the risk of adverse postoperative outcomes. Early identification of high-risk patients may improve perioperative management and reduce po

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Background: Surgical liver diseases encompass a broad spectrum of traumatic, infectious, benign, and malignant conditions associated with substantial morbidity and mortality worldwide. Data on the epidemiology and management of these conditions in sub-Saharan Africa remain scarce, limiting evidence-based planning and resource allocation. Objective: To describe the epidemiological characteristics, diagnostic patterns, therapeutic approaches, and outcomes of surgical liver diseases managed in referral hospitals in Douala, Cameroon. Methods: We conducted a retrospective multicenter cohort study in four referral hospitals in Douala, Cameroon, including the Douala General Hospital, Douala Laquintinie Hospital, Douala Gyneco-Obstetric and Pediatric Hospital, and the Regional Hospital. Medical records of adult patients managed for surgical liver diseases between January 2012 and December 2021 were reviewed. Patients with incomplete records were excluded. Data regarding demographics, risk factors, clinical presentation, laboratory findings, treatment modalities, and outcomes were extracted and analyzed using descriptive and comparative statistics. Results: Between January 2012 and December 2021, 9,749 patients were admitted to the participating surgical departments. Of these, 162 patients were diagnosed with a surgical liver disease, corresponding to a hospital prevalence of 1.66%. After excluding seven records with incomplete data, 155 patients were included in the final analysis. The 31–40-year age group was the most represented, and males accounted for 69.7% of cases (male-to-female ratio: 2.35:1). Primary liver tumors were the most frequent diagnosis (35.5%), followed by hepatic metastases (30.3%), liver trauma (25.2%), liver abscesses (6.5%), and hepatic cysts (2.6%). Hypertension (14.3%), hepatitis C infection (11.0%), hepatitis B infection (8.4%), and alcohol consumption (49.4%) were the most common risk factors. Abdominal pain was the leading presenting symptom (83.

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Postoperative peritonitis (POP) remains a severe complication of abdominal surgery, particularly in resource-limited settings, where delayed diagnosis and limited access to critical care contribute to poor outcomes. This study aimed to determine the prevalence, clinical characteristics, management modalities, and predictors of mortality among adults with postoperative peritonitis in Douala, Cameroon. We conducted a retrospective multicenter analytical study in two tertiary hospitals from January 2020 to December 2024. Adult patients diagnosed with postoperative peritonitis after abdominal or abdominopelvic surgery were included. Data were extracted from medical records and analyzed using univariate logistic regression. Among 4,763 laparotomies performed during the study period, 68 cases of postoperative peritonitis were identified, yielding a prevalence of 1.4%. After exclusion of incomplete records, 51 patients were included in the final analysis. The mean age was 35.4 ± 13.9 years, and women accounted for 82.4% of cases. Overall in-hospital mortality was 51.0%. The most frequent clinical features were abdominal pain (92.2%), abdominal guarding (86.3%), tachycardia (82.4%), and fever (76.5%). Deep suppuration (35.3%) and intestinal perforation (23.5%) were the most common intraoperative findings. Mortality was significantly associated with postoperative sepsis (OR 40.25, p<0.001), multiorgan failure (OR 37.84, p<0.001), vasopressor use (OR 17.60, p=0.002), prothrombin time <50% (OR 8.84, p=0.050), intensive care monitoring (OR 6.98, p=0.002), and blood transfusion (OR 4.55, p=0.020). Postoperative peritonitis remains an uncommon but highly lethal complication in our setting. Early diagnosis, prompt surgical source control, and

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Background: Temporary digestive stomas are frequently used in colorectal and emergency digestive surgery. Although digestive continuity restoration (DCR) improves quality of life and intestinal function, it remains associated with substantial postoperative morbidity. Data from sub-Saharan Africa remain scarce, particularly regarding predictors of adverse postoperative outcomes. Objective: To evaluate surgical practices, postoperative outcomes, and determinants of morbidity following digestive continuity restoration in three tertiary referral hospitals in Cameroon. Methods: A retrospective multicenter cohort study was conducted between January 2014 and December 2023 in three referral hospitals in Douala, Cameroon. Patients undergoing digestive continuity restoration after temporary digestive stoma formation were included. Sociodemographic, clinical, operative, and postoperative variables were analyzed. Factors associated with postoperative morbidity were identified using multivariable logistic regression. Results: Among 311 eligible patients, 264 were included in the final analysis. The mean age was 38.5 ± 18.7 years, and 55.7% were male. Infectious diseases (36.3%) and neoplastic conditions (26.1%) were the leading indications for temporary stoma creation. Colostomies accounted for 83.0% of all stomas. Peristomal mini-laparotomy was the most commonly used approach (59.1%). Overall postoperative morbidity reached 30.7%. Thirty-day mortality was 2.3%, while overall mortality during follow-up reached 5.7%. Previous stoma-related medical complications independently increased the risk of postoperative morbidity (aOR 4.64; 95% CI 2.16–9.97; p<0.001). ASA III status (aOR 3.45; 95% CI 1.40–8.47; p=0.007) and delayed restoration beyond 180 days (aOR 2.29; 95% CI 1.06–4.96; p=0.035) were also associated with increased morbidity. Conversely, the peristomal mini-laparotomy approach was protective (aOR 0.28; 95% CI 0.11–0.71; p=0.007). Conclusion: Digestive continuity restoratio

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Background: Post-mastectomy complications remain a major concern in patients with advanced breast cancer, particularly in low-resource settings where delayed diagnosis and advanced-stage presentation are common. This study aimed to identify factors associated with post-mastectomy complications among patients with advanced breast cancer in Douala, Cameroon. Methods: A multicenter cross-sectional analytical study was conducted in four reference hospitals in Douala from January 1, 2014, to December 31, 2023. A total of 523 patients who underwent mastectomy for histologically confirmed breast cancer were included. Sociodemographic, clinical, paraclinical, therapeutic, and postoperative data were collected using a structured form. Bivariate and multivariate logistic regression analyses were performed using SPSS software version 28.0. Statistical significance was set at p < 0.05. Results: The mean age of the patients was 47.0 ± 12.1 years. The most frequent post-mastectomy complications were lymphedema, anxiety, seroma, depression, pain, surgical site infection, sexual dysfunction, sensory disturbance of the arm, hemorrhage, and hematoma. In multivariate analysis, age 65–75 years, consultation delay of 6–9 months, invasive lobular carcinoma, and stage IIIb disease remained independently associated with post-mastectomy complications, whereas surgeon specialty lost statistical significance after adjustment. Conclusion: Advanced age, delayed consultation, invasive lobular carcinoma, and stage IIIb breast cancer were associated with post-mastectomy complications. Early diagnosis, timely surgical management, and multidisciplinary perioperative care may reduce postoperative morbidity and improve outcomes among patients with advanced breast cancer in Cameroon.