Cholecystectomy in children: Why and how?

Abstract

We aimed to evaluate etiology and outcome of children with cholecystectomy. Between June 2006 and June 2015, sixty one patients with cholecystectomy were reviewed in order to age, sex, indication, procedures, length of stay and complications. There were 35 female, 26 male, total of 61 patients (2 days -18 years, median 8 years). The indications for surgery were idiopathic cholelithiasis in 38 (62.2%), hemolytic anemia in 14 (22.9%), bile duct cyst in 5 (8.1%), gallbladder polyps in 2 (3.2%) and pancreatitis and short bowel syndrome in one (1.6%). Although the patients with cholelithiasis received ursodeoxycholic acid preoperatively, all of them needed cholecystectomy. Fifty (81.9%) patients underwent laparoscopic surgery, 11 (18.1%) patients open surgery. In those with open surgery, four patients’ indications were common bile duct cysts, only one patient needed the open surgery because of a previous surgery. The patients’ length of stay was between two days to 110 days (median five days). Postoperatively, three (4.9%) patients developed bile leakage. We just put a drain in one of them. The other two patients required a Roux-en-Y choledocojejunostomy. The patient with short bowel syndrome died. Although the number of indications and variations for cholecystectomy are growing, many of them are still grouped under the name of “idiopathic or nonhemolytic cholelithiasis”. Most of the cholecystectomies’ outcome are excellent, however, it is not a complication-free operation. 

Keywords

• Cholecystectomy
• Cholelithiasis
• Gallbladder
• Gallstone