Elective laparoscopic cholecystectomy: Treatment of choice for cholelithiasis in children with sickle cell disease?

• Published in: Surgical endoscopy Vol. 15; no. 3; pp. 301 - 304
• Main Authors: SEGUIER-LIPSZYC, E, DE LAGAUSIE, P, BENKERROU, M, DI NAPOLI, S, AIGRAIN, Y
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.05.2001; Springer Nature B.V
• Subjects: Abdomen; Automation; Bile ducts; Biological and medical sciences; Cholecystectomy; Emergency procedures; Gallbladder; Gallbladder diseases; Gallstones; Hyperthermia; Laparoscopy; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Morbidity; Patients; Pediatrics; Sickle cell anemia; Sickle cell disease; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Ultrasonic imaging; France; United States > US; Paris France; Human; Cholecystectomy; Endoscopic surgery; Hemoglobinopathy; Sickle cell anemia; Early stage; Hemopathy; Laparoscopy; Biliary tract disease; Genetic disease; Hemolytic anemia; Treatment; Lithiasis; Digestive diseases; Complication; Gallbladder; Child
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004640020022

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%). We performed a retrospective review of a series of 29 homozygous SS sickle cell children who underwent laparoscopic cholecystectomy between 1991 and April 1998. 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. 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.