Pediatric Laparoscopic Cholecystectomy: Clinical Significance of Cases

Abstract

Background: Cholecystectomy in children is relatively uncommon, despite being one of the most common surgical procedures in adults. However, the number of cholecystectomies in children has increased over the past two decades. The most common reason for juvenile patients to have cholecystectomy, according to a few research conducted on Western cultures, is biliary dyskinesia. However, in the majority of pediatric patients, gallstones are the cause of symptomatic gallbladder illness. The aim of this study was to describe the characteristics of pediatric patients who underwent laparoscopic cholecystectomy. Material & Methods: This was a retrospective study and was conducted in the Department of Pediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from May,2017 to February, 2020. In our study, we included 24 cases with gallbladder illness who underwent pediatric laparoscopic cholecystectomy. Results: A total 24 pediatric patients underwent laparoscopic cholecystectomy during the study period. Out of them 17 (70.8%) were 10 to 18 years old and 7 were below 10 years old. The cases comprised 10 male (41.7%) and 14 female (58.3%). Mean body weight was 53.3 Kg. Mean height was 151.3 cm and mean BMI was 24.43 Kg/m2,with 15 patients(62.5%) being overweight. Fever (83.3%) and vomiting (79.2%) were the most common presenting feature. Most of the cases (87.5%) presented with multiple gall stone. 33.3% of patient comes with anemia ,where hemolytic disorder is predominant comprising 29.3% of patient. Comparison between overweight and non overweight patients reveal that preoperative complications like CBD dilatation, CBD stone and choledocholithiasis were significantly high in overweight patients. Conclusion: In conclusion, cholecystectomy is rarely performed in pediatric populations. We found Laparoscopic cholecystectomy (LC) is a safe and effective treatment for pediatric cholelithiasis. The cause of the increased incidence of pediatric cholelithiasis is obesity and life style as well as its natural history, must be investigated further.