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ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2007, Number 3

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Cir Gen 2007; 29 (3)

Laparoscopic cholecystectomy in pediatric patients

Toiber LM, Cervantes CJ, Golffier RCE, Vidal GP, Shalkow KJ

Language: Spanish
References: 38
Page: 202-206
PDF size: 127.67 Kb.


ABSTRACT

Objective: To present our experience in laparoscopic cholecystectomy (LC) in children under 15 years of age.
Setting: ABC Medical Center.
Design: Observational, retrospective, comparative, and transversal.
Statistical analysis: Central tendency measures, Student’s t or Mann-Whitney U test and Fisher’s χ2 test.
Patients and methods: We reviewed the clinical records of all patients under 14 years of age subjected to LC from 1991 to May 2006. Studied variables were: age, gender, weight, symptomatology, time of symptoms before diagnosis, relevant antecedents, type of surgery, diagnostic studies, surgical time, transoperative cholangiography (TOC), endoscopic retrograde cholangiopancreatography (ERCP), and length of hospital stay; epidemiologic, etiologic, and clinical characteristics. We analyzed differences among subgroups and compared the results with those described in the literature.
Results: Eighteen children, 9 (50%) boys and 9 (50%) girls, age between 6 and 15 years (range 12.33 ± 3.09), weight between 20 and 94 kg (range 55.22 ± 19.10), were operated during the studied period. Indications were: cholelithiasis, 55.55%; biliary dyskinesia, 16-6%; acute alithiasic cholecystitis, 11.11%; and cholelithiasis, 11.11%. The most frequent relevant antecedent found was obesity in 38%. Right hypochondrium pain was the most common symptom (83.%), followed by vomiting in 55.6%, nausea in 50%, diffuse abdominal pain in 11.11%, fever, jaundice, and chronic constipation in one patient (5.55%). Surgical time was significantly (P = 0.027) greater in emergency surgery than in elective surgery.
Conclusions: LC is a safe and efficacious procedure for the treatment of pediatric patients.


REFERENCES

  1. Cervantes J. Historia de la colecistectomía por laparoscopia. En: Cervantes J, Patiño JF, Eds. Cirugía laparoscópica y toracoscópica. McGraw Hill Interamericana. México. 1997.

  2. Azuara-Fernández H, Skinfield-Fernández FJ, Azuara-Gutiérrez H, Torres-Cisneros JR, Rojas-Pavo F, Ballesteros-Loyo HJ, Gutiérrez-Fentanes A, Pérez R. Cirugía laparoscópica. Experiencia con los primeros casos operados. Bol Med Hosp Infant Mex 1993; 50: 39-43.

  3. Seleem MI, Al-Hashemy AM, Meshref SS. Mini-laparoscopic cholecystectomy in children under 10 years of age with sickle cell disease. ANZ J Surg 2005; 75: 562-5.

  4. Ortiz de la Peña J, Pardo A, Contreras A, Tamez J, Cañas M, Muñoz Infante J. La técnica de la colecistectomía laparoscópica en pediatría. Reporte de un caso. An Med Asoc Med Hosp ABC 1994; 39: 114-17.

  5. Granados-Romero JJ, Cabal-Jiménez K, Nieva-Kehoe R, Guerrero-Romero JF, Cervantes-Castro J. Colelitiasis en pacientes pediátricos y adolescentes y su tratamiento quirúrgico: reporte de dos centros hospitalarios de tercer nivel. Rev Mex Cir Endoscop 2001; 2: 75-78.

  6. Balaguer EJ, Price MR, Burd RS. National trends in the utilization of cholecystectomy in children. J Surg Res 2006; 134: 68-73.

  7. Gutiérrez V, Tamburri N, Bailez M. Colecistectomía laparoscópica en pediatría. Servicio de Cirugía Pediátrica. Hospital de Pediatría Juan P. Garrahan. Buenos Aires. Argentina.http://www.anestesiapediatrica.com.ar/colecistectomia_laparoscopica_en_pediatria.htm.

  8. Cervantes J, Rojas G, Parada S, Garmilla J, Cervantes A. Colecistectomía Laparoscópica. Experiencia inicial. An Med Asoc Med Hosp ABC 1991; 36: 96-101.

  9. Cervantes J, Rojas G, Vega G, Antón J. Colecistectomía por laparoscopia, octava, novena y décima décadas de la vida. Cir Ciruj 1995; 63: 169-73.

  10. Zamora J, Orozco O, Casillas M. Colecistectomía laparoscópica en edad Pediátrica. Rev Hosp Jua Mex 1994; 61: 5-6.

  11. Holcomb GW 3rd, Olsen DO, Sharp KW. Laparoscopic cholecystectomy in the pediatric patient. J Pediatr Surg 1991; 26: 1186-90.

  12. Cervantes J, Rojas G, Álvarez-González R, Padilla L. Colecistectomía laparoscópica en pediatría. Informe del primer caso en la literatura nacional. Bol Med Hosp Infant Mex 1992; 49: 380-383.

  13. Baeza E, Gutiérrez CE, Álvarez LA. Colecistectomía laparoscópica en niños. Rev Gastroenterol Mex 1998; 63: 17-20.

  14. Kumar R, Nguyen K, Shun A. Gallstones and common bile duct calculi in infancy and childhood. Aust N Z J Surg 2000; 70: 188-91.

  15. Friesen CA, Roberts CC. Cholelithiasis. Clinical characteristics in children. Case analysis and literature review. Clin Pediatr (Phila)1989; 28: 294-298.

  16. Stringer M, Taylor D, Soloway R. Gallstone composition: are children different? J Pediatr 2003; 142: 435-40.

  17. Ganesh R, Muralinath S, Sankaranarayanan VS, Sathiyasekaran M. Prevalence of cholelithiasis in children—a hospital-based observation. Indian J Gastroenterol 2005; 24: 85.

  18. Holcomb GW 3rd, Morgan WM 3rd, Neblett WW 3rd, Pietsch JB, O’Neill JA Jr, Shyr Y. Laparoscopic cholecystectomy in children: Lessons learned from the first 100 patients. J Pediatr Surg 1999; 34: 1236-40.

  19. Michail S, Preud’Homme D, Christian J, Nanagas V, Goodwin C, Hitch D, et al. Laparoscopic cholecystectomy: effective treatment for chronic abdominal pain in children with acalculous biliary pain. J Pediatr Surg 2001; 36: 1394-6.

  20. Darko R, Rodrigues OP, Oliver-Commey JO, Kotei CN. Gallstones in Ghanaian children with sickle cell disease. West Afr J Med 2005; 24: 295-8.

  21. Tomer G, Shneider BL. Disorders of bile formation and biliary transport. Gastroenterol Clin North Am 2003; 32: 839-55,vi.

  22. Lancellotti S, Zaffanello M, Di Leo E, Costa L, Lonardo A, Tarugi P. Pediatric gallstone disease in familial hypobetalipoproteinemia. J Hepatol 2005; 43: 188-91.

  23. Wen HH, Huang YK, Zheng GL. Ceftriaxone-associated gallbladder pseudolithiasis: report of one case. Acta Paediatr Taiwan 2004; 45: 290-292.

  24. Costa DL, Barbosa MD, Barbosa MT. Cholelithiasis associated with the use of ceftriaxone. Rev Soc Bras Med Trop 2005; 38: 521-523.

  25. Bor O, Dinleyici EC, Kebapci M, Aydogdu SD. Ceftriaxone-associated biliary sludge and pseudolithiasis during childhood: a prospective study. Pediatr Int 2004; 46: 322-324.

  26. Evliyaoglu C, Kizartici T, Bademci G, Unal B, Keskil S. Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation. Zentralbl Neurochir 2005; 66: 92-94.

  27. Vegunta RK, Raso M, Pollock J, Misra S, Wallace LJ, Torres A Jr, et al. Biliary Dyskinesia: the most common indication for cholecystectomy in children. Surgery 2005; 138: 726-731.

  28. Waldhausen JH, Graham DD, Tapper D. Routine intraoperative cholangiography during laparoscopic cholecistectomy minimizes unnecessary endoscopic retrograde cholangiopancreatography in children. J Pediatr Surg 2001; 36: 881-884.

  29. Bonnard A, Seguier-Lipszyc E, Ligoury C, Benkerrou M, Garel C, Malbezin S, et al. Laparoscopic approach as primary treatment of common bile duct stones in children. J Pediatr Surg 2005; 40: 1459-1463.

  30. Wewer AV, Hovendal CP, Paerregaard A. Gallstones in children. Ugeskr Laeger 2005; 167: 2625-2626.

  31. Robertson JF, Carachi R, Sweet EM, Raine PA. Cholelithiasis in childhood: a follow-up study. J Pediatr Surg 1988; 23: 246-9.

  32. Esposito C, Gonzalez SMA, Corcione F, Sacco R, Esposito G, Settimi A. Results and complications of laparoscopic cholecystectomy in childhood. Surg Endosc 2001; 15: 890-2.

  33. Buck J, Davies SC. Surgery in sickle cell disease. Hematol Oncol Clin North Am 2005; 19: 897-902, vii.

  34. Suell MN, Horton TM, Dishop MK, Mahoney DH, Olutoye OO, Mueller BU. Outcomes for children with gallbladder abnormalities and sickle cell disease. J Pediatr 2004; 145: 617-21.

  35. Curro G, Iapichino G, Lorenzini C, Palmeri R, Cucinotta E. Laparoscopic cholecystectomy in children with chronic hemolytic anemia. Is the outcome related to the timing of the procedure? Surg Endosc 2006; 20: 252-5.

  36. Ure BM, de Jong MM, Bax KN, van der Zee DC. Outcome after laparoscopic cholecystotomy and cholecystectomy in children with symptomatic cholecystolithiasis: a preliminary report. Pediatr Surg Int 2001; 17: 396-8.

  37. Escobar CH, Garcia NMD, Olivares P. Biliary lithiasis in childhood: therapeutic approaches. An Pediatr (Barc) 2004; 60: 170-4.

  38. Vrochides DV, Sorrells DL Jr, Kurkchubasche AG, Wesselhoeft CW Jr, Tracy TF Jr, Luks FI. Is there a role for routine preoperative endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis in children? Arch Surg 2005; 140: 359-61.




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