Laparoscopic versus open cholecystectomy in children.
Twenty-one consecutive laparoscopic cholecystectomies (LC) were compared with 29 consecutive open cholecystectomies (OC). Sickle-cell disease (SCD) was the most common reason for cholecystectomy in both groups. The average length of operative time for LC was significantly longer than that of OC (P=0.0149). In 1 patient there was conversion from LC to OC due to severe adhesions. Common bile duct (CBD) stones were diagnosed in 8 (27.6%) of the OC group; in 4 of them the diagnosis was made preoperatively by ultrasound, in 4 by intraoperative cholangiogram. All 8 patients required CBD exploration, and 2 had additional transduodenal sphincteroplasties. In the LC group 5 patients (23.8%) had CBD stones. All had (ERCP) endoscopic retrograde cholangiopancreatography sphincterotomy, and stone extraction followed by LC. ERCP is a necessary adjunct to treatment if LC is to be contemplated. Six patients in the OC group developed complications, while only 4 patients in the LC group developed minor complications. The length of hospitalization after LC was significantly shorter than after OC (P=0.0150). LC is the procedure of choice in the management of cholelithiasis in children, especially those with SCD.
Al-Salem
A H
AH
Division of Pediatric Surgery, Qatif Central Hospital, Qatif, Saudi Arabia.
Qaisaruddin
S
S
Al-Abkari
H
H
Nourallah
H
H
Yassin
Y M
YM
Varma
K K
KK
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D004586:Electrophoresis; D005260:Female; D006450:Hemoglobin SC Disease / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
D006454:Hemoglobins