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[Surgical treatment of cholelithiasis in children with sickle-cell anemia]
1Service de chirurgie pédiatriques, CHRU de la Guadeloupe, Pointe a Pitre, France.
Insights
Children with sickle cell disease often develop gallstones. Elective surgery for gallstones in these pediatric patients is recommended to prevent complications, especially when preceded by transfusion preparation.
Area of Science:
- Pediatric Surgery
- Hematology
- Gastroenterology
Context:
- Sickle cell disease (SCD) is a genetic blood disorder.
- Cholelithiasis (gallstones) is a known complication in children with SCD.
- This study reviewed surgical interventions for gallstones in pediatric SCD patients.
Purpose:
- To evaluate the outcomes of cholelithiasis surgery in children with sickle cell disease.
- To determine the optimal timing for surgical intervention.
- To assess the role of transfusion preparation in mitigating risks.
Summary:
- 37 children with sickle cell disease underwent surgery for gallstones between 1979 and 1990.
- The mean age was 11.3 years, with 24 experiencing recurrent abdominal pain and 8 facing acute complications.
- Systematic echography detected stones in 9 cases, highlighting the importance of early diagnosis.
- The increasing incidence of gallstones with age and complication rates support elective surgery upon diagnosis.
- Preoperative transfusion preparation significantly reduced postoperative complications.
Impact:
- Highlights the necessity of early gallstone detection and elective surgical intervention in pediatric SCD patients.
- Emphasizes the benefit of transfusion protocols in improving surgical outcomes for this high-risk group.
- Informs clinical practice regarding the management of cholelithiasis in sickle cell disease.
Abstract:
From 1979 to 1990 37 children with sickle cell disease underwent surgery for cholelithiasis. Mean age was 11,3 years. Twenty-four children had a history of recurrent abdominal pain; 8 of them were admitted for an acute gallstone complication. In 9 cases the stones were detected by systematic echography. The incidence of gallstones increasing with age, the rate of complications, the frequent resolution of recurrent abdominal pain after cholecystectomy justify elective surgery at the time of diagnostic of the stones. A transfusion preparation considerably reduces the risk of post-operative complications.