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Published on: February 28, 2025
Laparoscopic cholecystectomy for cholelithiasis in children
Deepak Javare Gowda1, Prakash Agarwal, Rajkishore Bagdi
1Department of Pediatric Surgery, Sri Ramachandra Medical College, Porur, Chennai - 600 116, India.
Insights
Laparoscopic cholecystectomy (LC) is a safe and effective treatment for pediatric gallstones. Further research is needed to understand the rising incidence and natural history of gallstones in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Cholelithiasis (gallstones) in children is increasingly recognized.
- The management of pediatric gallstones often requires surgical intervention.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic cholecystectomy (LC) for treating gallstones in pediatric patients.
- To assess the outcomes and complications associated with LC in this age group.
Main Methods:
- A retrospective review of 18 pediatric patients who underwent LC for cholelithiasis between April 2006 and November 2008.
- Data collected included patient demographics, clinical presentation, operative details, postoperative recovery, and histopathology.
Main Results:
- Eighteen children (mean age 9.4 years) underwent LC for cholelithiasis.
- The majority of cases (75.2%) were idiopathic, with pigmented gallstones being most common.
- LC demonstrated a low complication rate (11.1%) and a short hospital stay (average 4.1 days).
Conclusions:
- Laparoscopic cholecystectomy is a safe and effective surgical option for pediatric cholelithiasis.
- The etiology and natural history of pediatric gallstones warrant further investigation.
Aim:
To evaluate the role of laparoscopic cholecystectomy (LC) in the management of cholelithiasis in children.
Methods:
A retrospective review of our experience with LC for cholelithiasis at our institution, between April 2006 and November 2008, was done. Data included patient demographics, clinical history, hematological investigations, imaging studies, operative technique, postoperative complications, postoperative recovery, and final histopathological diagnosis.
Results:
During the study period of 32 months, 18 children (8 males and 10 females) with cholelithiasis were treated by LC. The mean age was 9.4 years (range 3-18). Seventeen children had symptoms of biliary tract disease and 1 child had incidentally detected cholelithiasis during an ultrasonography of abdomen for unrelated cause. Only 5 (27.8%) children had definitive etiological risk factors for cholelithiasis and the remaining 13 (75.2%) cases were idiopathic. Sixteen cases had pigmented gallstones and 2 had cholesterol gallstones. All the 18 patients underwent LC, 17 elective, and 1 emergency LC. The mean operative duration was 74.2 min (range 50-180). Postoperative complications occurred in 2 (11.1%) patients. The average duration of hospital stay was 4.1 days (range 3-6).
Conclusion:
Laparoscopic chloecystectomy is a safe and efficacious treatment for pediatric cholelithiasis. The cause for increased incidence of pediatric gallstones and their natural history needs to be further evaluated.
