Outcomes for children with gallbladder abnormalities and sickle cell disease.
OBJECTIVE
To determine whether elective cholecystectomy is justifiable in children with sickle cell disease (SCD), gallbladder abnormalities, and minimal clinical symptoms.


METHODS
A retrospective review comparing clinical presentations and abdominal ultrasound results with outcomes in 146 children with SCD.


RESULTS
Ultrasound examination showed sludge or stones in 83 of 146 children (57%). This was found during a diagnostic ultrasound in 59 patients (71%) and during a screening ultrasound in 24 asymptomatic patients (29%). Fifty-four (65%) children with a positive ultrasound underwent cholecystectomy; 13 of these were initially asymptomatic patients who had subsequent development of clinical symptoms. Of the patients with cholecystectomy, 93% had histopathologic evidence of cholecystitis. Perioperative complications were rare, and there were no episodes of postoperative acute chest syndrome. Children who underwent elective surgery had an average 12-days-shorter overall hospital stay than those who underwent emergent surgery (4 vs 16 days, P <.001).


CONCLUSIONS
Elective laparoscopic cholecystectomy may be safely performed in children with SCD. Surgery should be strongly considered at the time of gallstone diagnosis before symptoms or complications develop. Histopathologic chronic cholecystitis does not correlate with clinical symptoms.
Suell
Mary Nell
MN
Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, 77030, USA. mnsuell@texaschildrenshospital.org
Horton
Terzah M
TM
Dishop
Megan K
MK
Mahoney
Donald H
DH
Olutoye
Oluyinka O
OO
Mueller
Brigitta U
BU
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography