Laparoscopic cholecystectomy in patients with sickle cell disease.
Over a year (October 1992-September 1993), 30 patients (23 males and 7 females) with sickle cell anaemia and symptomatic gallstones underwent laparoscopic cholecystectomy (LC). The mean age was 26 years (range 15-44 years). The indications were: acute cholecystitis in four patients and long-standing biliary colic in the other 26. Twenty-four patients (80%) had a previous history of abdominal sickle cell crises. The preoperative HbF and HbS levels ranged from 18 to 33% and from 66 to 77.2%, respectively. The haemoglobin level ranged from 8.6 to 12 g% (mean 9.7 g%). Blood transfusion was given preoperatively to 19 patients (63%) and three patients needed perioperative transfusion. The mean operative time was 75 min (range 60-100 min). One of the four emergency cases was converted to open cholecystectomy due to difficult anatomy and inability to grasp a thick-walled, distended gallbladder. Two patients developed minor chest infections and one had an acute vaso-occlusive crisis on the fifth postoperative day and died despite the appropriate treatment (morbidity 6.6%, mortality 3.3%). The median hospital stay was 2 days (range 1-5 days). We believe that LC can be conducted safely in sickle cell patients with gallstones with minimal morbidity and mortality.
Meshikhes
A N
AN
Department of Surgery, Dammam Central Hospital, Saudi Arabia.
al-Dhurais
S A
SA
al-Jama
A
A
al-Faraj
A A
AA
al-Khatir
N S
NS
al-Abkar
H
H
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D001803:Blood Transfusion; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male