Related Experiment Videos
Laparoscopic cholecystecomy in a 16-day-old infant with chronic cholelithiasis
Michael Gertner1, Diana L Farmer
1Division of Pediatric Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA 94143-0570, USA.
Insights
This case study reports the first instance of chronic cholecystitis in a neonate, a 16-day-old infant who underwent laparoscopic cholecystectomy for gallstones.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Medicine
Background:
- Neonatal cholelithiasis is rare, often resolving spontaneously.
- Persistent or obstructive gallstones can lead to complications like ductal dilatation.
Purpose of the Study:
- To report the youngest patient undergoing laparoscopic cholecystectomy for cholelithiasis.
- To document the first case of chronic cholecystitis in a neonate.
Main Methods:
- Laparoscopic cholecystectomy with intraoperative cholangiogram.
- Ultrasound for diagnosis and monitoring.
- Histopathological examination of the gallbladder.
Main Results:
- A large, impacted gallstone was identified.
- Intrahepatic ductal dilatation indicated antenatal obstruction.
- Histopathology confirmed chronic cholecystitis.
Conclusions:
- Laparoscopic cholecystectomy is feasible and effective in neonates.
- Chronic cholecystitis can occur in neonates, necessitating surgical intervention.
- This represents the youngest patient reported for this procedure and condition.
Abstract:
A 16-day-old girl with demonstrated evidence of cholelithiasis was treated initially conservatively on the assumption that the gallstone would resolve spontaneously. However, when repeat ultrasound scan showed a large gallstone and intrahepatic ductal dilatation indicative of antenatal common duct obstruction, the infant underwent laparoscopic cholecystectomy with an intraoperative cholangiogram. The patient did well postoperatively and was on regular feeding by postoperative day 1. An intraoperative cholangiogram showed an impacted stone in the infidibulum of the gallbladder. Gross and histopathologic findings indicated chronic cholecystitis. Based on an extensive review of the literature, this case appears to be the first reported incidence of chronic cholecystitis in a neonate and that of the youngest patient to undergo a laparoscopic cholecystectomy with intraoperative cholangiogram.
