Multicenter Study of Laparoscopic Common Bile Duct Exploration for Choledocholithiasis in the English-Speaking Caribbean.

Background Common bile duct (CBD) exploration to address choledocholithiasis is not widely practiced in the English-speaking Caribbean. This study sought to determine the frequency of laparoscopic CBD explorations in the English-speaking Caribbean and to document the stone clearance rates and short-term outcomes of this procedure. Methods We accessed records for all practicing laparoscopic surgeons in the English-speaking Caribbean who performed laparoscopic CBD explorations over a 10-year period from January 1, 2013, to June 30, 2023. The following data were extracted retrospectively from patient records: demographic details, operating time, stone clearance rates, retained stone rates, conversions, and complications. All data were analyzed with SPSS version 20 (IBM Corp., Armonk, NY). Results Over the 10-year study period, 35 patients underwent laparoscopic cholecystectomy and synchronous CBD exploration in Barbados, Cayman Islands, Guyana, Grenada, St Lucia, and Trinidad & Tobago. The procedure was performed at low volumes of only 0.7 procedures per surgical team per annum. The conversion rate to open CBD exploration was 13% and when laparoscopic CBD exploration was completed, it resulted in 96.3% stone clearance, 3.7% retained stones, mean hospitalization of two days, 9.7% minor morbidity, and no mortality. Conclusion Laparoscopic CBD exploration is feasible in the resource-poor Caribbean setting, and it yields good results, with 96.3% stone clearance rates, 9.7% minor morbidity, and no mortality. These results are better than those reported in Caribbean literature for stone extraction with endoscopic retrograde cholangiopancreaticography (ERCP).

Major Hospital Fire in Saint Lucia.

This paper provides a field report on a hospital fire at the St. Jude hospital in the Eastern Caribbean Island of Saint Lucia. The hospital was completely destroyed by the fire and three deaths were recorded. This paper analyses the emergency response to this hospital fire and discusses the lessons learned from this experience. This is a valuable lesion for developing countries in the Caribbean, especially since there have been four hospital fires reported in the Caribbean within the past decade.

Socio-demographic features of cocaine dependence: a pilot study - abstract

Cocaine use is epidemic in Trinidad and Tobago and is a cause of pressing social and health care concerns. This study reviews some socio-demographic features of the first 100 in-patients for cocaine dependence to the Substances Abuse Treatment Centre (SATC) in 1990. There were no females in this sample and 86 percent were between the ages of 20 and 39 years, 67 percent were either single, separated or divorced and 53 percent were employed at the time of admission. Forty-five per cent had a positive family history of substance abuse and 27 percent had been treated peviously for psychiatric illness other than substance abuse. In this sample, Africans accounted for 52 percent while East Indians contributed 26 percent. Interestingly, 70 percent of the patients admitted to using other drugs beside cocaine while 28 percent used cocaine only. Thirty-four per cent of the sample had been exposed to rehabilitation and treatment facilities prior to their admission to SATC and clinic follow-up with the urine testing revealed that 81 percent had relapsed by the end of six (6) months (AU)