Laparoscopic cholecystectomy in childhood: a review of twenty-four consecutive cases

Abstract

Background. The experience with laparoscopic cholecystectomy in children remains limited. Therefore, we aimed to present our experience with this procedure. Methods. Between April 2011 and June 2016, retrospectively, data points of children who underwent laparoscopic cholecystectomy reviewed included demographics properties, indication for cholecystectomy, surgical technique, operative time, complications, and length of hospital stay. Results. Twenty-four children (5 were males with ages ranging from 2 to 17 years, mean: 10.5 years) underwent laparoscopic cholecystectomy. The indication for surgery was associated to symptomatic gallstones in all patients. The surgery was performed under general anesthesia and classical 4-port approach was done in twenty-two patients, and 2-port approach in combination with 2 portless 2.3-mm percutaneous graspers was used in two patients. The operating time ranged between 45 and 90 minutes (mean: 60 minutes). Two patients ended by open surgery. No complications occurred. Hospital stays ranged from 1-3 days. Conclusion. Laparoscopic cholecystectomy is safe and effective in children, and shows the same advantages reported in adults series. 

Keywords

• Laparoscopy,Cholecystectomy,Cholelithiasis,Children

References

1. [1] Garey CL, Laituri CA, Keckler SJ, Ostlie DJ, Stagg HW, Little DC, et al. Laparoscopic cholecystectomy in obese and non-obese children. J Surg Res 2010;163:299-302.
2. [2] Mesas Burgos C, Ghaffarpour N, Almstrom M. Single-site incision laparoscopic cholecystectomy in children: a single-center initial experience. J Pediatr Surg 2011;46:2421-5.
3. [3] Esposito C, Gonzalez Sabin MA, Corcione F, Sacco R, Esposito G, Settimi A. Results and complications of laparoscopic cholecystectomy in childhood. Surg Endosc 2001;15:890-2.
4. [4] Gowda DJ, Agarwal P, Bagdi R, Subramanian B, Kumar M, Ramasundaram M, et al. Laparoscopic cholecystectomy for cholelithiasis in children. J Indian Assoc Pediatr Surg 2009;14:204-6.
5. [5] Koebnick C, Smith N, Black MH, Porter AH, Richie BA, Hudson S, et al. Pediatric obesity and gallstone disease. J Pediatr Gastroenterol Nutr 2012;55:328-33.
6. [6] Bailey PV, Connors RH, Tracy TF, Jr., Sotelo-Avila C, Lewis JE, Weber TR. Changing spectrum of cholelithiasis and cholecystitis in infants and children. Am J Surg 1989;158:585-8.
7. [7] Curro G, Iapichino G, Lorenzini C, Palmeri R, Cucinotta E. Laparoscopic cholecystectomy in children with chronic hemolytic anemia. Is the outcome related to the timing of the procedure? SurgEndosc 2006;20:252-5.
8. [8] Siddiqui S, Newbrough S, Alterman D, Anderson A, Kennedy A, Jr. Efficacy of laparoscopic cholecystectomy in the pediatric population. J Pediatr Surg 2008;43:109-13.

9. [9] St Peter SD, Keckler SJ, Nair A, Andrews WS, Sharp RJ, Snyder CL, et al. Laparoscopic cholecystectomy in the pediatric population. J Laparoendosc Adv Surg Tech A 2008;18:127-30.
10. [10] Haricharan RN, Proklova LV, Aprahamian CJ, Morgan TL, Harmon CM, Barnhart DC, et al. Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief. J Pediatr Surg 2008;43:1060-4.
11. [11] Lacher M, Yannam GR, Muensterer OJ, Aprahamian CJ, Haricharan RN, Perger L, et al. Laparoscopic cholecystectomy for biliary dyskinesia in children: frequency increasing. J Pediatr Surg 2013;48:1716-21.
12. [12] Reynolds W, Jr. The first laparoscopic cholecystectomy. JSLS 2001;5:89-94.
13. [13] Holcomb GW, 3rd, Olsen DO, Sharp KW. Laparoscopic cholecystectomy in the pediatric patient. J Pediatr Surg 1991;26:1186-90.
14. [14] Newman KD, Marmon LM, Attorri R, Evans S. Laparoscopic cholecystectomy in pediatric patients. J Pediatr Surg 1991;26:1184-5.
15. [15] Ergun O, Tiryaki S, Celik A. Single center experience in single-incision laparoscopic surgery in children in Turkey. J Pediatr Surg 2011;46:704-7.
16. [16] Chandler NM, Danielson PD. Single-incision laparoscopic cholecystectomy in children: a retrospective comparison with traditional laparoscopic cholecystectomy. J Pediatr Surg 2011;46:1695-9.