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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
PubMed
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).

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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).

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  • 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.