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Updated: Apr 10, 2026
Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
[Laparoscopic cholecystectomy: what we can learn about]
Insights
Laparoscopic cholecystectomy (LC) is a safe procedure in children, similar to adults, despite longer operating times. Further research can optimize recovery and discharge for pediatric patients undergoing LC.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Context:
- Laparoscopic cholecystectomy (LC) is common in adults but less frequent in children.
- Assessing pediatric LC outcomes is crucial for surgical practice.
- Comparing pediatric and adult LC outcomes provides valuable insights.
Purpose:
- To evaluate the outcomes of laparoscopic cholecystectomy (LC) in children compared to adults.
- To identify differences in operating time, conversion rates, complication rates, length of stay, and time to first feeding.
- To determine the safety and efficacy of pediatric LC.
Summary:
- A study compared 39 children and 40 adults undergoing LC, with cholelithiasis as the primary indication in both groups.
- Pediatric LC had longer operating times (127 min vs. 71 min) but similar conversion and complication rates (5% vs. 2.5%).
- Children experienced longer hospital stays (2.1 days vs. 0.5 days) and delayed first feeding (21 hours vs. 8 hours) compared to adults.
Impact:
- Laparoscopic cholecystectomy in children is a safe procedure with comparable morbidity to adults.
- Longer hospital stays in pediatric patients may be due to less familiarity with the technique.
- Future efforts should focus on reducing operative time, time to first feeding, and length of hospital stay for pediatric LC.
Background:
Laparoscopic cholecystectomy (LC) is a very usual procedure within adult population, but not as frequent in childhood. The aim of this study was to assess the outcome of LC in children compared with those performed in adulthood.
Materials And Methods:
We reviewed 39 consecutive patients who underwent LC between 2003 and 2013 at our Department and a similar sample of patients from 18 to 40 years of age from the General Surgery Department.
Results:
39 children and 40 adults fulfilled criteria to be included in the study. The most frequent indication was cholelithiasis in both groups. The mean operating time was significantly higher among children (127 min, adults 71 min, p < 0.01) but we didn't find differences neither in conversion nor in complication rates (children 5% and 7.7%, adults 2.5% and 15% respectively). In regard to preoperative factors, only male gender was correlated to a higher complication rate (p 0.037). On the other hand we found out that, in absence of complications, both the average length of stay (children 2.1 days, adults 0.5 days) and mean time to first feeding (children 21 hours, adults 8 hours) were significantly higher among children (p < 0.01).
Conclusions:
1) LC in childhood is a safe procedure that does not imply more morbidity than the same intervention in adults, even though a more prolonged operating time. 2) We believe that our longer hospital stay is due to certain lack of confidence with the technique and, in the future, the trend should be bent on encouraging a shorter time to first feeding and an earlier discharge.
