The role of laparoscopic cholecystectomy in the management of acute cholecystitis in patients with sickle cell disease.
BACKGROUND
As emergency surgery in sickle cell disease patients is associated with high morbidity, the aim of the study was to assess the safety of laparoscopic cholecystectomy in the acute state for these patients.


METHODS
Over a 5-year period, April 1994 till December 1998, 35 sickle cell patients with acute cholecystitis had laparoscopic cholecystectomy within the first 5 days of presentation. A retrospective study of these was undertaken.


RESULTS
Thirty-five patients were diagnosed as having acute cholecystitis with sickle cell disease. There were 26 female and 9 male patients; 5 patients needed preoperative and 1 patient needed postoperative endoscopic retrograde cholangiopancreatography. Twenty-seven patients needed simple transfusion and 8 needed partial exchange; conversion was necessary in two cases (5.7%). The mean hospital stay was 5.3 days and the complication rate was 17.5%.


CONCLUSIONS
Because of the lack of significant complications, we believe that laparoscopic cholecystectomy for acute cholecystitis is safe and recommended in experienced hands with adequate preoperative preparation for patients with sickle cell disease.
Al-Mulhim
Abdulrahman Saleh
AS
Department of Surgery, King Fahad Hospital, Hofuf, Al Hassa, Saudi Arabia. abdu3939@yahoo.com
Al-Mulhim
Faisal Mohammed
FM
Al-Suwaiygh
Abdulmohsen Abdulla
AA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome