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Laparoscopic cholecystectomy in children with sickle cell disease
AbdulRahman S Al-Mulhim1, Magdy M Abdulatif, Adel M Ali
1Department of Surgery, King Fahad Hospital-Hofuf, Hofuf, Al-Hassa, Saudi Arabia. abdu3939@ yahoo.com
Insights
Elective laparoscopic cholecystectomy in children with sickle cell disease is recommended. Emergency surgeries showed longer operating times, hospital stays, and more complications compared to routine procedures.
Area of Science:
- Pediatric Surgery
- Hematology
- Gastrointestinal Surgery
Background:
- Sickle cell disease (SCD) presents unique challenges in pediatric surgical care.
- Cholelithiasis (gallstones) is a common complication in children with SCD.
- Laparoscopic cholecystectomy is a standard procedure for gallstone disease.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic cholecystectomy in pediatric patients with sickle cell disease.
- To compare surgical outcomes between emergency and elective (routine) cholecystectomy in this cohort.
Main Methods:
- Retrospective review of 72 pediatric patients (<14 years) who underwent cholecystectomy over 5 years.
- Comparison of operative time, hospital stay, and postoperative complications between emergency and routine surgical groups.
Main Results:
- Emergency laparoscopic cholecystectomy cases had significantly longer mean operating times (91.3 min vs. 75.8 min) and hospital stays (8.5 days vs. 4.5 days).
- The incidence of postoperative complications was higher in the emergency surgery group.
Conclusions:
- Elective laparoscopic cholecystectomy, performed by experienced surgeons with appropriate precautions, is a safe and recommended approach for children with sickle cell disease and cholelithiasis.
- Urgent surgical intervention in SCD patients may lead to increased morbidity.
Background:
The aim of this study was to report the outcome of laparoscopic cholecystectomy in children with sickle cell disease and to compare the patients who had surgery as emergency with those who were operated as routine.
Materials And Methods:
A total of 72 patients (males 48, females 24) less than 14 years of age (ranging between 6 and 14 years) underwent cholecystectomy at the King Fahad Hospital, Hofuf, in the last 5 years. The records of these patients were reviewed retrospectively, comparing the outcome of surgery in emergency and routine cases.
Results:
The mean operating time and the mean hospital stay were longer in the emergency group (91.3 min, 8.5 days) compared to routine group (75.8 min, 4.5 days respectively), with high incidence of postoperative complication in the emergency group.
Conclusion:
This study showed that elective laparoscopic cholecystectomy by an experienced surgeon and taking necessary precautions are the safety measures to be recommended at the time of diagnosis of cholelithiasis in sickle cell disease children.
