Laparoscopic cholecystectomy in children: One centre experience

Abstract

The incidence of cholelithiasis in children is assessed to range from 0.13 to 1.9%. Symptomatic cholelithiasis in children requiring surgery has increased in tendency over the past ten years. Food habits, obesity and family history are the most common risk factors. Aim of the study was evaluation of the indications, methods and results of cholelithiasis treatment in children. From June 2011 to December 2014, 74 consecutive patients aged 3–18 years were treated due to symptomatic cholelithiasis. In 72 patients, laparoscopic cholecystectomy (LC) was performed; in the analyzed group there were 56 girls and 18 boys. A total of 48 patients underwent an elective operation. Urgent hospitalization was required by 26 patients due to acute biliary colic in 16, cholecystitis in five, hydrops of the gallbladder in two, jaundice in two and acute pancreatitis in one patient. LC was performed after resolution of symptoms. In all cases except four, LC was performed with the three-port technique. In four cases of spherocytosis, splenectomies were completed during the same procedure and requiring insertion of an additional fourth port.There were no intraoperative complications demanding reoperation. Minor complications included postoperative vomiting requiring antiemetic medications in 28 patients, pain located in the shoulder region in nine patients and elevation of temperature in the postoperative period in eight. Laparoscopic surgery is a safe procedure in children for removal of the gallbladder. Age of the patient is not a contraindication to the operation, and LC may be performed even in young children with symptomatic gallbladder disease.