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Updated: Jul 9, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
[Pediatric laparoscopic cholecystectomy]
Gabriela Ambriz-González1, Carlos David Bañuelos, Luis Gómez-Hermosillo
1Departamento de Cirugía Pediádrica, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Jaime Nuno 938, Col. Chapultepec Country, 44600 Guadalajara, Jalisco, Mexico. ggaby03@yahoo.com
Insights
Laparoscopic cholecystectomy effectively treats symptomatic cholelithiasis (gallstones) in children. This minimally invasive surgery showed high success rates with minimal complications in pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Context:
- Symptomatic cholelithiasis is increasingly diagnosed in pediatric populations.
- Laparoscopic cholecystectomy is the standard surgical approach for gallstones in adults.
- The efficacy and safety in pediatric patients require specific evaluation.
Purpose:
- To evaluate the outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis in pediatric patients.
- To assess the safety and effectiveness of this minimally invasive technique in children.
- To identify risk factors and associated pathologies in pediatric gallstone disease.
Summary:
- A 5-year study of 47 pediatric patients (<18 years) undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis.
- The procedure demonstrated high effectiveness with a low conversion rate (2.1%) and no major morbidity or mortality.
- Postoperative follow-up confirmed all patients were asymptomatic, with female patients exhibiting risk factors similar to adult populations.
Impact:
- Laparoscopic cholecystectomy is a highly effective treatment for pediatric symptomatic cholelithiasis.
- Findings suggest an increasing incidence of gallstones in children, necessitating familiarity with minimally invasive techniques among pediatric surgeons.
- Identified female pediatric patients have risk factors mirroring adult gallstone disease patterns.
Background:
We undertook this study to evaluate the results of surgical treatment of symptomatic cholelithiasis through laparoscopic cholecystectomy in a series of 47 consecutive pediatric patients.
Methods:
During a 5-year period (2001-2005) we performed laparoscopic cholecystectomy in 47 patients <18 years old in one institution by the same surgical team. The population was comprised of 41 girls and 6 boys (age range: 6-18 years). All had symptomatic cholelithiasis confirmed at ultrasound examination. Associated pathology was studied in each case. The surgical procedure consisted of a four-port laparoscopic cholecystectomy under CO(2) pneumoperitoneum. No other concomitant procedure was performed in any case.
Results:
Median age was 14.6 years old. The youngest patient of the series had a hematological disease. In girls we identified obesity in 62.5% of patients, with a body mass index (BMI) of 26.6 kg/m(2) (SD 3.0) vs. 21.5 kg/m(2) (SD 3.0) in boys (p <0.05), 30% of the girls had a positive medical history for pregnancies (range 1-3) and 15% regularly used oral contraceptives. All cases were symptomatic and 13% suffered from acute biliary pancreatitis. Average surgical time was 59.8 min, the conversion rate was 2.1% and the most frequent surgical complication was gallbladder rupture. No major morbidity was observed as well as no mortality. Postoperatively, all patients were asymptomatic, with a minimum follow-up time of 6 months.
Conclusions:
Laparoscopic cholecystectomy was highly effective in cases of symptomatic cholelithiasis. Etiologically, females showed risk factors for cholelithiasis similar to those usually observed in adults. Probably in the near future the incidence of cholelithiasis will increase in this age group. Pediatric surgeons should be familiarized with the minimal access technique to treat this disease.
