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Laparoscopic versus open cholecystectomy in children
A H Al-Salem1, S Qaisaruddin, H Al-Abkari
1Division of Pediatric Surgery, Qatif Central Hospital, Qatif, Saudi Arabia.
Pediatric Surgery International
|January 1, 1997
Summary
Laparoscopic cholecystectomy (LC) is preferred for pediatric gallstones, even in sickle-cell disease (SCD) patients. While operative time may be longer, LC offers shorter hospital stays and fewer complications compared to open cholecystectomy (OC).
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Hematology
Background:
- Cholelithiasis is common in children, particularly those with sickle-cell disease (SCD).
- Surgical management options include laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).
Purpose of the Study:
- To compare the outcomes of LC versus OC in pediatric patients undergoing cholecystectomy.
- To evaluate the safety and efficacy of LC in children with SCD.
Main Methods:
- Retrospective comparison of 21 LC procedures with 29 OC procedures.
- Analysis of operative time, complications, common bile duct (CBD) stone management, and length of hospitalization.
Main Results:
- LC operative time was longer than OC (P=0.0149), but hospitalization was significantly shorter (P=0.0150).
- CBD stones were present in 23.8% of LC patients and 27.6% of OC patients, requiring endoscopic retrograde cholangiopancreatography (ERCP) in the LC group.
- Fewer complications were observed in the LC group (4 minor) compared to the OC group (6).
Conclusions:
- Laparoscopic cholecystectomy is the preferred surgical approach for pediatric cholelithiasis, including in patients with SCD.
- ERCP is a crucial adjunct for managing CBD stones during LC.
- LC offers advantages in terms of reduced hospital stay and complication rates.