Unique features of laparoscopic cholecystectomy in Beta thalassemia patients.
Beta Thalassemia patients suffer from a high incidence of gallstones as well as systemic complications of iron overload. We performed laparoscopic cholecystectomy in 8 beta thalassemia patients and describe their specific features. Diagnosis was based on patients' clinical presentation and sonography. Trocars were readjusted due to the hepatomegaly. No intraoperative cholangiograms were performed. Follow-up included clinical assessment and abdominal sonography. All procedures were completed laparoscopically. Pigment cirrhosis and fibrosis around the cystic duct were noted in all patients. No biliary injury occurred. Post operatively, 4 patients suffered fluid leakage through the trocar site, treated conservatively. No major cardiopulmonary complications occurred. During a mean follow-up time of 65 months, all patients are symptom free and without evidence of biliary lithiasis. Thalassemia patients are difficult and often high-risk patients. Improvement in anesthesia and monitoring enables better management of these patients. Laparoscopic cholecystectomy should be advised in carefully selected thalassemia patients.
Katz
Ran
R
Departments of General Surgery, Hadassah Medical Center, Hebrew University, Ein Kerem, Jerusalem, Israel. rank@cc.huji.ac.il
Goldfarb
Ada
A
Muggia
Michael
M
Gimmon
Zvi
Z
D000328:Adult; D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000209:etiology / Q000601:surgery*; D002908:Chronic Disease; D003085:Colic / Q000209:etiology / Q000601:surgery*; D005260:Female; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000150:complications / Q000601:surgery*