Feasibility and outcomes of 3-port laparoscopic cholecystectomy in the pediatric population

Year 2019, Volume: 5 Issue: 2, 1518 - 1527, 15.08.2019

Mustafa Erman Dörterler Tansel Günendi

https://doi.org/10.30569/adiyamansaglik.546757

Abstract

Objective: The objective of this
retrospective study was to describe our experience with 3-port laparoscopic
cholecystectomy in a total 20 pediatric patients.

Method: Data on patient demographics,
indication for cholecystectomy, surgical technique, operative time (minutes),
complications and length of hospital stay (LOS, day) were recorded.

Result: Mean (SD) operative
time was 44.8  (9.5, range: 30.0-60.0)
minutes and LOS was 2.1(1.2, range: 1.0-5.0) days. Surgery was successful in
all patients without development of major complications. Apart from
significantly shorter operative time in patients with cholelithiasis than those
with other indications for laparoscopic cholecystectomy (median 42.2 vs. 55.0
min, p=0.001), no significant difference was noted in age, operative time and
LOS with respect to gender or indications.

Conclusion: Our findings indicate safety and
efficacy and feasibility of 3-port laparoscopic cholecystectomy in the
pediatric population, regardless of indication or gender along with significant
advantages regarding the operative time, complication rates and hospital stay.

 

Keywords

Laparoscopic cholecystectomy, pediatric population, cholelithiasis, hospital stay, complications

Feasibility and outcomes of 3-port laparoscopic cholecystectomy in the pediatric population

Abstract

Objective: The objective of this
retrospective study was to describe our experience with 3-port laparoscopic
cholecystectomy in a total 20 pediatric patients.

Method: Data on patient demographics,
indication for cholecystectomy, surgical technique, operative time (minutes),
complications and length of hospital stay (LOS, day) were recorded.

Result: Mean (SD) operative
time was 44.8  (9.5, range: 30.0-60.0)
minutes and LOS was 2.1(1.2, range: 1.0-5.0) days. Surgery was successful in
all patients without development of major complications. Apart from
significantly shorter operative time in patients with cholelithiasis than those
with other indications for laparoscopic cholecystectomy (median 42.2 vs. 55.0
min, p=0.001), no significant difference was noted in age, operative time and
LOS with respect to gender or indications.

Conclusion: Our findings indicate safety and
efficacy and feasibility of 3-port laparoscopic cholecystectomy in the
pediatric population, regardless of indication or gender along with significant
advantages regarding the operative time, complication rates and hospital stay.

Keywords

Laparoscopic cholecystectomy, pediatric population, cholelithiasis, hospital stay, complications

References

• 1. Poffenberger CM, Gausche-Hill M, Ngai S, et al. Cholelithiasis and its complications in children and adolescents: update and case discussion. Pediatr Emerg Care 2012;28:68-76.
• 2. Elsadat AM, Hussien A, Sattar A, et al. A Trial to Plan Management of Cholelithiasis According to Presenting Feature in Pediatric Age (Experience with 30 cases). Annals Pedia Surg 2009;5:241-6.
• 3. Bălănescu RN, Bălănescu L, Drăgan G, et al. Biliary Lithiasis with Choledocolithiasis in Children. Chirurgia (Bucur) 2015;110:559-61.
• 4. Siddiqui S, Newbrough S, Alterman D, et al. Efficacy of laparoscopic cholecystectomy in the pediatric population. J Pediatr Surg 2008;43:109-13.
• 5. Barthel ER, Pierce JR, Zmora O, et al. Calcified gallstone in a 3 year-old boy: a case report. BMC Res Notes 2012;5:433.
• 6. Bibza J, Sykora L, Cingel V, et al. Laparoscopic cholecystectomy in children. Bratisl Lek Listy 2013;114:230-1.
• 7. Espinosa-Saavedra D1, Flores-Calderón J, González-Ortiz B, et al. Characteristics of pediatric patients with biliary lithiasis: Immediate post-operative evolution. Rev Med Inst Mex Seguro Soc 2014;52:74-7. [Article in Spanish]
• 8. St Peter SD, Keckler SJ, Nair A, et al. Laparoscopic cholecystectomy in the pediatric population. J Laparoendosc Adv Surg Tech A 2008;18:127-30.
• 9. Zeidan MM1, Pandian TK, Ibrahim KA, et al. Laparoscopic cholecystectomy in the pediatric population: a single-center experience. Surg Laparosc Endosc Percutan Tech 2014;24:248-50.
• 10. Till H, Wachowiak R, Marinoni F, et al. Laparoendoscopic single site cholecystectomy (LESS) in a 16-year-old girl: the way to go even in pediatric surgery? Zentralbl Chir 2010;135:188-9. doi: 10.1055/s-0029-1224683. [Article in German]
• 11. Hansen EN, Muensterer OJ, Georgeson KE, et al. Single-incision pediatric endosurgery: lessons learned from our first 224 laparoendoscopic single-site procedures in children. Pediatr Surg Int 2011;27:643-8.
• 12. Matayoshi N, Sato N, Okimoto T, et al. A Review of 7 Cases of Laparoscopic Cholecystectomy for Pediatric Cholecystolithiasis. J UOEH 2017;39:223-7. [Article in Japanese]
• 13. Papandreou E, Gentimi F, Baltogiannis N, et al. Laparoscopic cholecystectomy in children: A 5-year experience. Pediatrics 2008;121:163-4.
• 14. Esposito C, Gonzalez Sabin MA, Corcione F, et al. Results and complications of laparoscopic cholecystectomy in childhood. Surg Endosc 2001;15:890-2.
• 15. Poddar U. Gallstone disease in children. Indian Peds 2010;47:945-53.
• 16. Currò G, Meo A, Ippolito D, et al. Asymptomatic cholelithiasis in children with sickle cell disease: early or delayed cholecystectomy? Ann Surg 2007;245:126-9
• 17. Cairo SB, Ventro G, Meyers HA, et al. Influence of discharge timing and diagnosis on outcomes of pediatric laparoscopic cholecystectomy. Surgery 2017;162:1304-13.
• 18. Schinasi DA, Mistry RD. Cholelithiasis in a toddler with sickle cell disease. Pediatr Emerg Care 2011; 27:533-4