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Outcomes for children with gallbladder abnormalities and sickle cell disease

Mary Nell Suell1, Terzah M Horton, Megan K Dishop

  • 1Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, 77030, USA. mnsuell@texaschildrenshospital.org

The Journal of Pediatrics
|November 3, 2004
PubMed

Insights

Elective gallbladder removal (cholecystectomy) is safe for children with sickle cell disease (SCD) and gallbladder issues. Early surgery before symptoms arise can prevent complications and shorten hospital stays.

Area of Science:

  • Pediatric Surgery
  • Hematology
  • Gastroenterology

Background:

  • Sickle cell disease (SCD) patients often have gallbladder abnormalities.
  • Gallbladder issues in SCD can lead to serious complications.

Purpose of the Study:

  • To evaluate the safety and efficacy of elective cholecystectomy in children with SCD, gallbladder abnormalities, and minimal symptoms.
  • To determine if early surgical intervention is beneficial.

Main Methods:

  • Retrospective review of 146 children with SCD.
  • Analysis of clinical presentations, abdominal ultrasound findings, and surgical outcomes.
  • Comparison of elective versus emergent cholecystectomy.

Main Results:

  • Gallbladder sludge or stones detected in 57% of children via ultrasound.
  • 65% of those with abnormalities underwent cholecystectomy; 13 were initially asymptomatic.
  • 93% had histopathologic evidence of cholecystitis.
  • Elective surgery patients had significantly shorter hospital stays (4 vs. 16 days).
  • No major perioperative complications or acute chest syndrome episodes.

Conclusions:

  • Elective laparoscopic cholecystectomy is a safe and effective option for children with SCD and gallbladder disease.
  • Strong consideration for surgery upon gallstone diagnosis, before symptom onset, is recommended.
  • Histopathologic findings of chronic cholecystitis did not consistently correlate with clinical symptoms.
Abstract

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