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Related Experiment Video

Updated: Mar 8, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

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Two-Incision Laparoscopic Cholecystectomy in Children.

Sarah W Lai1,2, Steven S Rothenberg2, Kristin E Shipman2

  • 11 Alberta Children's Hospital , Calgary, Alberta, Canada .

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|January 14, 2017
PubMed
Summary

Two-incision laparoscopic cholecystectomy (2I-LC) is a safe alternative for pediatric gallbladder disease, comparable to four-port laparoscopic cholecystectomy (4P-LC). Overweight children may require additional ports during 2I-LC.

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Area of Science:

  • Pediatric surgery
  • Minimally invasive surgery
  • Gastrointestinal surgery

Background:

  • Laparoscopic cholecystectomy is standard for pediatric gallbladder disease.
  • Minimally invasive techniques aim to reduce scarring and improve cosmesis.
  • Two-incision laparoscopic cholecystectomy (2I-LC) offers a potentially less invasive approach compared to traditional four-port laparoscopic cholecystectomy (4P-LC).

Purpose of the Study:

  • To evaluate the safety and efficacy of 2I-LC in pediatric patients.
  • To compare the outcomes of 2I-LC with 4P-LC in children and adolescents (≤21 years).

Main Methods:

  • Retrospective review of 389 pediatric patients undergoing 2I-LC or 4P-LC between 2010 and 2016.
  • 2I-LC utilizes two 5-mm ports and a 2-mm grasper within a single umbilical incision, plus a 3-mm subxiphoid port.
Keywords:
cholecystectomylaparoscopypediatrictwo-incision

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  • Comparison of demographic, operative, and outcome data between the two groups using statistical tests.

    • Main Results:

    • 2I-LC was performed in 72% of cases, with 4P-LC in 19%.
    • Higher Body Mass Index (BMI) was noted in the 4P-LC group.
    • Operative times were longer for 4P-LC. Conversion rates from 2I-LC to 4P-LC were 2.4%, associated with higher BMI and operative time.

    Conclusions:

    • 2I-LC is a safe and viable alternative for pediatric gallbladder disease, facilitating critical view of the anatomy.
    • Longer operative times in 4P-LC may be due to patient selection bias (higher BMI, complex gallstone disease).
    • Increased BMI is a predictor for requiring additional ports during 2I-LC.