Laparoscopic cholecystectomy in the pediatric population: a single-center experience.

Abstract

We aimed to review our experience with laparoscopic cholecystectomy in the pediatric population to better understand the associated complications and outcomes. We performed a retrospective chart review of children below 18 years of age who underwent laparoscopic cholecystectomy at a single academic institution between the years 1990 and 2010. Of the 325 cases of cholecystectomy, 202 (62.2%) were performed laparoscopically. The primary indication for surgery was symptomatic cholelithiasis (45.5%, n=92). Preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed in 25 (12.4%) patients. Variations in anatomy and technical difficulties (eg, presence of adhesions) were observed in 45 (22.3%) patients. Intraoperative cholangiogram was performed in 20 (9.9%) patients and 16 (7.9%) underwent concomitant splenectomy. Only 8 (4%) of the cases were converted to an open approach because of lack of anatomic clarity. There were zero common bile duct injuries; however, spillage of bile was present in 12 (5.9%) patients. Postoperative complications including wound infection, retained stones, abdominal abscess, and biloma, were observed in 9 patients (4.5%). The median operative time was 117.5 minutes. The median postoperative hospital stay was 1 day. Nineteen (9.4%) patients had recurrence of abdominal pain without associated pathology. Three patients (1.5%) required postoperative ERCP. The average follow-up period was 54 months. Laparoscopic cholecystectomy in the pediatric population results in short postoperative hospital stay and has low complication rates. In particular, zero bile duct injuries were noted.