Abstract
Background
Gallbladder stones are very common in patients with sickle cell disease and are the cause of recurrent abdominal pain. Their management has been highly controversial, especially for children. Nonoperated patients and those treated on an emergency basis have a very high rate of morbidity (>50%).
Methods
We performed a retrospective review of a series of 29 homozygous SS sickle cell children who underwent laparoscopic cholecystectomy between 1991 and April 1998.
Results
Only in one case a conversion was necessary (early in the series). Exploration of the common bile duct was done via intraoperative cholangiography. There were no mortalities. The morbidity rate was 17%; (however, of the five patients concerned, four suffered from hyperthermia for 2 days). All of the children were improved and enjoyed resolution of their abdominal pain.
Conclusions
We believe that elective laparoscopic cholecystectomy at the earliest time possible, along with correct perioperative management, is the treatment of choice for cholelithiasis in children with sickle cell disease.
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References
Barrett-Connor E (1968) Cholelithiasis in sickle cell anemia. Am J Med 45: 889–898
Bhattacharyya N, Wayne AS. Kevy SV, Shamberger RC (1993) Perioperative management for cholecystectomy in sickle cell disease. J Pediatr Surg 28: 72–75
Everson GT, Nemeth A (1989) Gallbladder function is altered in sickle hemoglobinopathy. Gastroenterology 96: 1307–1316
Gholson CF, Capier JF (1995) Sequential endoscopic/laparoscopic management of sickle hemoglobinopathy—associated cholelithiasis and suspected choledocholithiasis. South Med J 88: 1131–1135
Go PMNYH, Stolk MFJ (1995) Symptomatic gallbladder stones: cost-effectiveness of treatment with extracorporeal shock-wave lithotripsy, conventional and laparoscopic cholecystectomy. Surg Endosc 9: 37–41
Haberkern CM, Neumayr LD (1997) Cholecystectomy in sickle cell anemia patients: perioperative outcome of 364 cases from the National Preoperative Transfusion Study. Blood 89: 1533–1542
Hatley RM, Crist D, Howell CG, Herline AJ, Gadacz MD (1995) Laparoscopic cholecystectomy in children with sickle cell disease. Am Surg 61: 169–171
Holcomb GW III, Oslen DO, Sharp KW (1991) Laparoscopic cholecystectomy in the pediatrie patient. J Pediatr Surg 26: 1186–1190
Jawad AJ, Kurban K. el-Bakry A, al-Rabeeah A, Seraj M, Ammar A (1998) Laparoscopic cholecystectomy for cholelithiasis during infancy and childhood: cost analysis and review of current indications. World J Surg 22: 69–73 DOI: 10.1007/s002689900351
Kim PCW, Wesson D. Superina R, Filler R (1995) Laparoscopic cholecystectomy versus open cholecystectomy in children: which is better? J Pediatr Surg 30: 971–973
Koshy M, Weiner SJ (1995) Surgery and anesthesia in sickle cell disease. Blood 86: 3676–3684
Kum CK, Wong CW, Goh PMY, Ki TK (1994) Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy. Surg Laparosc Endosc 4: 139–141
Lagausie P (de), Eymeri JC, Tavakoli D (1989) Intérêt de la cholecystectomie réglée chez l’enfant drépanocytaire homozygote. A propos de trois observations récentes. Ann Chir 43: 361–362
Malone BS, Werlin SL (1988) Cholecystectomy and cholelithiasis in sickle cell anemia. Am J Dis Child 142: 799–800
Newman KD, Marmon LM, Attorri R, Evans S (1991) Laparoscopic cholecystectomy in pediatric patients. J Pediatr Surg 26: 1184–1185
Perrissat J, Collet D (1992) Laparoscopic cholecystectomy: the state of the art: a report on 700 consecutive cases. World J Surg 16: 1074–1082
Peters JH, Ortega A (1993) The physiology of laparoscopic surgery: pulmonary function after laparoscopic cholecystectomy. Surg Laparosc Endosc 3: 370–374
Rennels MB, Dunne MG (1984) Cholelithiasis in patients with major sickle hemoglobinopathies. Am J Dis Child 138: 66–67
Schauer PR, Sirinek KR (1995) The laparoscopic approach reduces the endocrine response to elective cholecystectomy. Am Surg 61: 106–111
Sézeur A. Benoit J (1993) Cholécystectomie élective par coelioscopie versus abord sous-costal. Etude comparative de la douleur et du confort post-opératoire. Gastroenterol Clin Biol 17: 833–838
Sigman HH, Laberge JM (1991) Laparoscopic cholecystectomy: a treatment option for gallbladder disease in children. J Pediatr Surg 26: 1181–1183
Simi M, Schietroma M, Carlei F, Iannucci D, Cianca G, Leardi S (1996) Is laparoscopic cholecystectomy a safe alternative to open cholecystectomy for pediatrie patients with cholelithiasis? Endoscopy 28: 312–315
The Southern Surgeons Club A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324: 1073–1078
Steiner CA, Bass EB, Talamini MA, Pitt HA, Steinberg EP (1994) Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland. N Engl J Med 330: 403–408
Tagge EP, Otherson HB Jr (1994) Impact of laparoscopic cholecystectomy on the management of cholelithiasis in children with sickle cell disease. J Pediatr Surg 29: 209–213
Vanek VW, Rhodes R, Dallis DJ (1995) Results of laparoscopic versus open cholecystectomy in a community hospital. South Med J 88: 555–566
Walker TM, Serjeant GR (1996) Biliary sludge in sickle cell disease. J Pediatr 129: 443–445
Ware RE, Kinney TR, Casey JR, Pappas TN, Meyers WC (1992) Laparoscopic cholecystectomy in young patients with sickle hemoglobinopathies. J Pediatr 120: 58–61
Wiesel S, Grillas R (1995) Patient controlled analgesia after laparoscopic and open cholecystectomy. Can J Anaesth 42: 37–40
Winter SS, Kinney TR, Ware RE ( ) Gallbladder sludge in children with sickle cell disease. J Pediatr 125: 747–749
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Séguier-Lipszyc, E., de Lagausie, P., Benkerrou, M. et al. Elective laparoscopic cholecystectomy. Surg Endosc 15, 301–304 (2001). https://doi.org/10.1007/s004640020022
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DOI: https://doi.org/10.1007/s004640020022