We aimed to review our experience with laparoscopic cholecystectomy in the pediatric population to better understand the associated complications and outcomes.
We performed a retrospective chart review of children below 18 years of age who underwent laparoscopic cholecystectomy at a single academic institution between the years 1990 and 2010.
Of the 325 cases of cholecystectomy, 202 (62.2%) were performed laparoscopically. The primary indication for surgery was symptomatic cholelithiasis (45.5%, n=92). Preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed in 25 (12.4%) patients. Variations in anatomy and technical difficulties (eg, presence of adhesions) were observed in 45 (22.3%) patients. Intraoperative cholangiogram was performed in 20 (9.9%) patients and 16 (7.9%) underwent concomitant splenectomy. Only 8 (4%) of the cases were converted to an open approach because of lack of anatomic clarity. There were zero common bile duct injuries; however, spillage of bile was present in 12 (5.9%) patients. Postoperative complications including wound infection, retained stones, abdominal abscess, and biloma, were observed in 9 patients (4.5%). The median operative time was 117.5 minutes. The median postoperative hospital stay was 1 day. Nineteen (9.4%) patients had recurrence of abdominal pain without associated pathology. Three patients (1.5%) required postoperative ERCP. The average follow-up period was 54 months.
Laparoscopic cholecystectomy in the pediatric population results in short postoperative hospital stay and has low complication rates. In particular, zero bile duct injuries were noted.
Department of Surgery, Division of Pediatric Surgery, Mayo Clinic, Rochester, MN
The authors declare no conflicts of interest.
Reprints: Abdalla E. Zarroug, MD, FACS, FAAP, Department of Surgery, Division of Pediatric Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (e-mail: firstname.lastname@example.org).
Received April 27, 2013
Accepted July 11, 2013