Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Gallstones in children are rare but can become a potentially serious condition [1,2]. Symptomatic
cholelithiasis that is requiring surgery in children has been increased in tendency over the last 10
years. The incidence of cholelithiasis in children ranges from 0.13 to 1.9 % and when compared
with the adult population , the risk of cholelithiasis incidence is assessed to be as 10–15 % . The
experience of pediatric surgical centers is estimated to be very scarce (3,4) . Contemporary
Laparoscopic Cholecystectomy is considered as the gold standard procedure in the management of
gallbladder diseases in both adults and children . Children that are considered to be a candidates for
surgery should be operated in pediatric surgery clinics experienced in minimally invasive
techniques (3) .
OBJECTIVE:
Pediatric laparoscopic cholecystectomy has not been evaluated in Iraq , here is an evaluation of
the procedure for 29 cases is presented mainly to study its application in this group of patients.
PATIENTS AND METHODS:
This is a preliminary study of 29 cases of pediatric laparoscopic cholecystectomy performed in
Erbil city in the period from 2011 to 2017. Age range was 5 months -11 years, 21 males & 8
females . Three of them were obese & one overweight . Both , three millimeter & 5 mm ports were
used , 4 ports were inserted .
RESULTS:
Out of 29 cases, 21 (72.42 %) were males & 8 (27.58 %) were females, ranging from 5 months –
11 yrs . Twenty – five of the cases were electively operated on . Oral feeding started after 6 hrs ,
patients were discharged after 8 hrs except two patients who stayed for 36 hrs , mean hospital stay
was 13 hrs and 42 min . The mean operative time was 31 min (range from 20 min to 60 min) . The
was laparoscopic cholecystectomy performed by single specialist pediatric surgeon. All cases were
done as day case surgery except for the emergency cases. The time of hospitalization ranged from
8 hrs to 3 days. There were no intra operative complications that require reoperation such as injury
to the common bile duct or other viscera, bile leakage or vascular injury.
CONCLUSION:
Laparoscopic surgery is a safe procedure in children for excising the gall bladder . Age of the
patient is not a contraindication to operation , and LC may be performed even in young children
with symptomatic gall bladder disease with low morbidity . it should therefore be considered as the
procedure of choice in pediatric patients (10,11) .