Indications and Outcome of Cholecystectomy in Paediatric Population

Cholecystectomy in Paediatric Population

Abstract

Background: With the introduction of laparoscopy the surgical management of gallstones has been revolutionized. Presently this minimally invasive technique has virtually become the gold standard in the management of cholelithiasis. Its use in paediatric population is newer as compared to the general population. Subjects and methods: We present our series of 47 children with gall stones disease over a period of 7 yrs who were treated with laparoscopic cholecystectomy at Govt. Medical College hospital Srinagar during 7-year period from March 2005 through March 2012. 31 patients were male and 16 female. The mean age was 13 years, with a range of 6 to 15 years. In each case, the indication for operation was symptomatic cholelithiasis. Gallstones were documented before surgery by ultrasonography in each patient. Majority of the children were having no causative factors for gallstones. Safety and efficacy of the procedure was evaluated and the children were followed up for symptom relief and complication of the procedure in the OPD clinics. Results: 47 patients under went lap cholecystectomy.21 patients were male and 26 female. The mean age was 13 years, with a range of 6 to 15 years. The mean duration of surgery was 45 +_15 minutes. Most of the patients tolerated oral diet 6-8 hrs after surgery. All patients were discharged once they tolerated oral diet. No long-term biliary complications were seen in these patients during an mean follow-up period of 12.5 months (range = 2-22 months). Conclusion : Laparoscopic cholecystectomy in paediatric cholelithiasis is a safe and effective surgical procedure when it is performed by an experienced surgeon having good experience of minimal access procedures and sound knowledge of biliary anatomy. It is simple and safe as compared to general population.