Laparoscopic or open cholecystectomy in patients with sickle cell disease: which approach is superior?
OBJECTIVE
To compare laparoscopic with open cholecystectomy in patients with sickle cell disease.


METHODS
Retrospective clinical study.


METHODS
University hospital, Greece.


METHODS
41 patients (22 men and 19 women) with sickle cell disease had laparoscopic cholecystectomy between September 1991 and June 1998. Each patient was matched for age, sex, year of operation, and number of preoperative transfusions with control patients with sickle cell disease who had open cholecystectomy.


METHODS
Duration of operation, postoperative stay in hospital, incidence of complications, and conversion to open operation.


RESULTS
The mean operation time was 81.4 min (range 55-125) for open cholecystectomy and 64.2 min (range 45-90) for laparoscopic cholecystectomy (p < 0.01). Complications occurred in 5% (2/41) of the patients in the laparoscopic group and in 20% (8/41) of the patients in the open group (p = 0.04). The mean length of stay in hospital was 5.6 days (range 3-9) in the open group and 2.7 days (range 2-5) in the laparoscopic group (p < 0.01). Conversion to open operation was necessary in 2 (5%) patients.


CONCLUSIONS
Laparoscopic cholecystectomy resulted in a shorter hospital stay with fewer postoperative complications than open operation in patients with sickle cell disease and may be the procedure of choice in the treatment of cholelithiasis in such patients.
Leandros
E
E
1st Department of Propedeutic Surgery, University of Athens, Greece.
Kymionis
G D
GD
Konstadoulakis
M M
MM
Albanopoulos
K
K
Dimitrakakis
K
K
Gomatos
I
I
Androulakis
G
G
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000755:Anemia, Sickle Cell / Q000150:complications*; D002763:Cholecystectomy / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors