Results and complications of laparoscopic cholecystectomy in childhood

Esposito, Ciro; Sabin, Miguel Antonio González; Corcione, Francesco; Sacco, Rosario; Esposito, Giovanni; Settimi, Alessandro

doi:10.1007/s004640000042

Cited by 45 publications

(36 citation statements)

References 20 publications

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“…Surgical options for pediatric cholelithiasis include open or laparoscopic cholecystectomy [8] . At the present, laparoscopic technique is considered the gold standard for cholecystectomy in children for reduced pain, absence of an upper abdominal incision and scar formation and a shorter period of hospitalization [9][10][11][12] . The non-surgical approach is based on the use of ursodeoxycholic acid (UDCA); UDCA can reduce cholesterol saturation in bile and progressively dissolve cholesterol gallstones [13,14] .…”

Section: Resultsmentioning

confidence: 99%

Management of cholelithiasis in Italian children: A national multicenter study

Corte¹,

Falchetti²,

Nebbia³

et al. 2008

WJG

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development of complications was reported. CONCLUSION:The therapeutic strategies were extremely heterogeneous. Ursodeoxycholic acid was ineffective in dissolution of gallstones but it had a positive effect on the symptoms. Laparoscopic cholecystectomy was confirmed to be an efficacy and safe treatment for pediatric gallstones. INTRODUCTIONIn the last years following the extensive use of ultrasound scanning an increasing number of children with cholelithiasis has been identified. In a population based study, prevalence of gallstones and biliary sludge in children was of 1.9% and 1.46%, respectively [1] . In an analogue study, performed in Italian adults, the overall prevalence of gallstones diseases was of 9.5% in men and 18.9% in women [2] . Gallstones disease is the most common and costly of all digestive disease in the United States, resulting in 700 000 cholecystectomies and as many as 1 000 000 hospitalizations annually [3] . The frequency of hospital admission and operation for gallstones increased in Western countries since the 1950s [4] . In England the age-standardized hospital admission rate for cholelithiasis enhanced from 68.7 to 104.9 per 100 000 population between 1989/1990 and 1999/2000 and it increased progressively with age from 1.1 per 100 000 in the 0-14 year age group to 277.1 per 100 000 in the ≥ 85-year age group in 1999/2000 [5] . Guidelines for management of cholelithiasis are available for adults. Cholecystectomy is recommended for

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Section: Resultsmentioning

confidence: 99%

Management of cholelithiasis in Italian children: A national multicenter study

Corte¹,

Falchetti²,

Nebbia³

et al. 2008

WJG

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“…Esposito et al [3] stated that non-calcified stones may spontaneously resolve within 3-6 months. Nonetheless, symptomatic or incidentally detected asymptomatic calcified stones should be intervened through a surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

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

2016

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Objectives. 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 adult series.

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“…La coexistencia de coledocolitiasis (8,5% de los casos), es comparable con otras experiencias, tanto pediátricas como de adultos, por lo que no parece haber diferencia en la presentación de esta comorbilidad en este grupo de edad 13,16 . La morbimortalidad registrada, es similar a series de adultos, contrario a lo que uno pudiese pensar por ser sujetos anatómicamente más pequeños, hecho que pudiera significar un mayor riesgo de MPO 4,17 . La estadía hospitalaria (mediana de 2 días), es mayor tanto a lo que se observa en la práctica cotidiana como en reportes de colecistectomía laparoscópica en población adulta; lo que podría explicarse dado el temor de un "alta precoz" en pacientes, que además de ser pediátricos, son principalmente de domicilio rural (el hospital de Puerto Montt, es centro de referencia de toda la Región de Los lagos).…”

Section: Tabla 4 Enfermedades Concomitantes Verificadasunclassified

“…La estadía hospitalaria (mediana de 2 días), es mayor tanto a lo que se observa en la práctica cotidiana como en reportes de colecistectomía laparoscópica en población adulta; lo que podría explicarse dado el temor de un "alta precoz" en pacientes, que además de ser pediátricos, son principalmente de domicilio rural (el hospital de Puerto Montt, es centro de referencia de toda la Región de Los lagos). De todos modos, en comparación con otras series pediátricas la estancia hospitalaria es similar [17][18][19][20] . A modo de conclusión, podemos señalar que colelitiasis en menores de 15 años no es muy habitual pero su tratamiento mediante una colecistectomía laparoscópica presenta una frecuencia de MPO que es baja, similar a la cirugía en adultos y con otras series de pacientes pediátricos encontradas en la literatura 16,17 .…”

Section: Tabla 4 Enfermedades Concomitantes Verificadasunclassified

“…De todos modos, en comparación con otras series pediátricas la estancia hospitalaria es similar [17][18][19][20] . A modo de conclusión, podemos señalar que colelitiasis en menores de 15 años no es muy habitual pero su tratamiento mediante una colecistectomía laparoscópica presenta una frecuencia de MPO que es baja, similar a la cirugía en adultos y con otras series de pacientes pediátricos encontradas en la literatura 16,17 . referencias…”

Section: Tabla 4 Enfermedades Concomitantes Verificadasunclassified

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Morbilidad en Pacientes Pediátricos Sometidos a Colecistectomía Laparoscópica

et al. 2015

Rev Chil Cir

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morbidity in pediatric patients undergoing laparoscopic cholecystectomy introduction: Cholelithiasis is a prevalent disease in Chile. Therefore, there is sufficient evidence regarding the results of cholecystectomy in adults; however, information in pediatric population is scarce. The aim of this study is to report the results of a series of pediatric patients undergoing surgery for cholelithiasis, in terms of postoperative morbidity (POM). material and methods: Retrospective case series. All patients undergoing laparoscopic cholecystectomy for cholelithiasis in the period 2004 to 2013, in the Department of Surgery of Hospital de Puerto Montt, Chile, were included. The main outcome variable was POM. Other variables of interest were cause of consult, coexistence of choledocholithiasis, concomitant diseases, nature of surgery, hospital stay and mortality. Descriptive statistics were used to calculate percentages, measures of center tendency and dispersion. results: 71 patients, with a median age of 13 years, 84.5% female, were operated. POM was 1.4% (one case of hemoperitoneum that required reoperation, Dindo-Clavien IIIb). The most frequent cause of consultation was biliary colic (95.8% of cases). Coexistence of choledocholithiasis was determined in 6 cases (8.5%). The most common concomitant disease was familiar microspherocytosis (4 cases, 5.6%). The surgery was elective in 62 patients (87.3%). Median hospital stay were 2 days. The serie has no mortality. conclusion: The observed results are comparable with those from other series of laparoscopic cholecystectomy in pediatric patients.

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Results and complications of laparoscopic cholecystectomy in childhood

Cited by 45 publications

References 20 publications

Management of cholelithiasis in Italian children: A national multicenter study

Management of cholelithiasis in Italian children: A national multicenter study

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

Morbilidad en Pacientes Pediátricos Sometidos a Colecistectomía Laparoscópica

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