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Laparoscopic cholecystectomy in children with sickle cell disease
R M Hatley1, D Crist, C G Howell
1Department of Surgery, Medical College of Georgia, Augusta.
Insights
Laparoscopic cholecystectomy in children with sickle cell disease may lead to complications. Outpatient or short-stay procedures are not recommended due to risks like bleeding and vaso-occlusive events.
Area of Science:
- Pediatric surgery
- Hematology
Background:
- Laparoscopic cholecystectomy has been used in children with sickle cell disease since 1991.
- Benefits include reduced pain and shorter hospital stays.
Observation:
- This study questions the suitability of outpatient or 24-hour hospitalization for these patients.
- Perioperative complications are a significant concern.
Findings:
- Complications include bleeding diathesis, vaso-occlusive phenomena, and delayed hemolytic transfusion reactions.
- These risks persist even with normal clotting parameters.
Implications:
- Careful consideration of perioperative risks is crucial for children with sickle cell disease undergoing cholecystectomy.
- Current protocols for short-stay procedures may need re-evaluation.
Abstract:
Since 1991, laparoscopic cholecystectomy has been utilized in children with sickle cell disease, predominantly because of the decreased pain and shorter hospitalization. We believe that outpatient laparoscopic cholecystectomy or even a 24 hour hospitalization is not indicated in the patient with sickle cell disease. Perioperative complications include bleeding diathesis, vaso-occlusive phenomena, and delayed hemolytic transfusion reactions, although clotting parameters can be normal.