Medium-term results after cholecystectomy in patients younger than 10 years

G. Mattioli, P. Repetto, C. Carlini, C. Granata, G. Montobbio, A. Cagnazzo, A. Barabino, P. Gandullia, V. Jasonni

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Gallbladder stones are a well-known and widely studied problem in children. Hematological disorders are the most common diseases that can cause cholelithiasis. However, in the last few years, the proportion of children with idiopathic cholelithiasis has increased 50%. Herein, we present a prospective study on laparoscopic cholecystectomy in a selected group of patients aged <10 years. Methods: Fifty-eight patients aged <10 years underwent laparoscopic cholecystectomy for stones in the period 1992-99. The female/male ratio was 1.5, the mean age was 8 years (range, 2-10), and the mean weight was 30 kg. In all patients, parenteral nutrition, fasting state, and prolonged use of antibiotics had been suspended for ≥ 6 months, and conservative treatment had been tried for ≥ 12 months in the absence of symptoms of stone migration. All the patients were followed up after surgery: clinically at 1,6,12, and 36 months and by ultrasound at 1, 12, and 36 months. Liver function and hematological tests were performed in case of symptoms or if hemolytic disorders were the cause of stones. Results: The mean operative time was 63 min (range, 30-12) in children undergoing Cholecystectomy alone and 150 min in children undergoing associated splenectomy. There were no major complications or reoperations. Minor complications included bleeding from accessory cystic artery (n = 3) and insufflation of the omentum (n = 2). One case was converted to an open procedure due to technical problems. All the children were followed up and no complications were observed. Conclusion: We consider the laparoscopic approach the gold standard for cholecystectomy in children. This procedure does not have a complication rate any higher than open cholecystectomy, and patient follow-up is as good as that of open surgery. Previous abdominal surgery is not a contra-indication to laparoscopy.

Original languageEnglish
Pages (from-to)1423-1426
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Volume15
Issue number12
Publication statusPublished - 2001

Fingerprint

Cholecystectomy
Cholelithiasis
Laparoscopic Cholecystectomy
Insufflation
Omentum
Liver Function Tests
Parenteral Nutrition
Hematologic Tests
Splenectomy
Operative Time
Gallbladder
Reoperation
Laparoscopy
Fasting
Arteries
Prospective Studies
Hemorrhage
Anti-Bacterial Agents
Weights and Measures

Keywords

  • Cholecystectomy
  • Gallbladder stones
  • Laparoscopy
  • Pediatric surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Medium-term results after cholecystectomy in patients younger than 10 years. / Mattioli, G.; Repetto, P.; Carlini, C.; Granata, C.; Montobbio, G.; Cagnazzo, A.; Barabino, A.; Gandullia, P.; Jasonni, V.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 15, No. 12, 2001, p. 1423-1426.

Research output: Contribution to journalArticle

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AU - Repetto, P.

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AU - Granata, C.

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AU - Cagnazzo, A.

AU - Barabino, A.

AU - Gandullia, P.

AU - Jasonni, V.

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AB - Background: Gallbladder stones are a well-known and widely studied problem in children. Hematological disorders are the most common diseases that can cause cholelithiasis. However, in the last few years, the proportion of children with idiopathic cholelithiasis has increased 50%. Herein, we present a prospective study on laparoscopic cholecystectomy in a selected group of patients aged <10 years. Methods: Fifty-eight patients aged <10 years underwent laparoscopic cholecystectomy for stones in the period 1992-99. The female/male ratio was 1.5, the mean age was 8 years (range, 2-10), and the mean weight was 30 kg. In all patients, parenteral nutrition, fasting state, and prolonged use of antibiotics had been suspended for ≥ 6 months, and conservative treatment had been tried for ≥ 12 months in the absence of symptoms of stone migration. All the patients were followed up after surgery: clinically at 1,6,12, and 36 months and by ultrasound at 1, 12, and 36 months. Liver function and hematological tests were performed in case of symptoms or if hemolytic disorders were the cause of stones. Results: The mean operative time was 63 min (range, 30-12) in children undergoing Cholecystectomy alone and 150 min in children undergoing associated splenectomy. There were no major complications or reoperations. Minor complications included bleeding from accessory cystic artery (n = 3) and insufflation of the omentum (n = 2). One case was converted to an open procedure due to technical problems. All the children were followed up and no complications were observed. Conclusion: We consider the laparoscopic approach the gold standard for cholecystectomy in children. This procedure does not have a complication rate any higher than open cholecystectomy, and patient follow-up is as good as that of open surgery. Previous abdominal surgery is not a contra-indication to laparoscopy.

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