Multidimensional impacts of the Lebanese economic crisis on the management of acute cholecystitis.

BACKGROUND

Lebanon's overlapping economic collapse, COVID-19 pandemic, and Beirut port explosion have profoundly strained healthcare delivery. We assessed their impact on the severity and surgical management of acute cholecystitis.

METHODS

We conducted a retrospective cohort study of 554 patients who underwent cholecystectomy between 2018 and 2024, comparing a pre-crisis period (2018-January 2020) with a crisis period (February 2020-2024). Monthly interrupted time series analyses and multivariable logistic regression models adjusting for age, ASA class, and inflammatory markers were performed.

RESULTS

Crisis-period patients presented later (median 2 vs 1 day) with higher WBC counts. The proportion of Tokyo Grade II-III cholecystitis increased from 22.5 % to 44.9 %, and the crisis period independently predicted higher severity (adjusted OR 3.27; 95 % CI 2.10-5.10). Postoperative complication and readmission rates remained stable.

CONCLUSION

Lebanon's crises were associated with delayed presentation and more severe acute cholecystitis, without worsening adjusted postoperative outcomes.