Efficacy of laparoscopic cholecystectomy in the pediatric population
| Autor: | Alfred Kennedy, Daniel M. Alterman, Scott Newbrough, Alan E. Anderson, Sabina Siddiqui |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Ileus Adolescent medicine.medical_treatment Gallbladder disease Biliary dyskinesia Biliary colic Risk Assessment Severity of Illness Index Biliary disease Cohort Studies Age Distribution Postoperative Complications medicine Humans Minimally Invasive Surgical Procedures Sex Distribution Child Probability Retrospective Studies Ultrasonography Pain Postoperative medicine.diagnostic_test business.industry General surgery Incidence General Medicine Length of Stay medicine.disease Surgery Treatment Outcome Cholescintigraphy Dyskinesia Cholecystectomy Laparoscopic Child Preschool Pediatrics Perinatology and Child Health Cholecystectomy Female medicine.symptom business Biliary Dyskinesia Follow-Up Studies |
| Zdroj: | Journal of pediatric surgery. 43(1) |
| ISSN: | 1531-5037 |
| Popis: | Purpose Gallbladder disease is increasingly affecting the pediatric population. The advent of new technology in the 1980s, specifically, hepatobiliary scintigraphy and laparoscopic cholecystectomy, gave a dramatic rise in both the diagnosis and treatment of biliary disease in the pediatric population. The purpose of this study was to determine ( a ) whether laparoscopic cholecystectomy for biliary dyskinesia is efficacious in the treatment of children with biliary colic and ( b ) the ability of cholescintigraphy to predict which patients may benefit from an operative intervention. Methods We performed a retrospective review of the records of all patients (N = 184) who underwent laparoscopic cholecystectomy, correlating postoperative results with degree of dyskinesia (percentage of ejection fraction), histopathology, associated gastrointestinal diagnoses, age, and sex. Biliary dyskinesia was defined by ultrasonography without evidence of cholelithiasis with clinical diagnosis of biliary colic. Results Of the 184 patients who underwent laparoscopic cholecystectomy, 117 had a diagnosis of biliary dyskinesia and 108 were available for follow-up. Mean follow-up was 8.3 months. One hundred patients (92.6%) reported resolution or improvement of preoperative symptoms (64.8% reported complete resolution and 27.8% reported improvement in symptoms). The mean age of the patients was 14.1 years. No correlation was seen for degree of dyskinesia, histopathology, age, and sex. Patients with a preoperative diagnosis of gastroesophageal reflux were more likely to report resolution of symptoms, although this finding was not statistically significant. There was no major complication; 1 patient suffered a prolonged ileus, 1 patient suffered a wound infection, and 1 patient required incisional hernia repair. Conclusion Laparoscopic cholecystectomy is safe, efficacious, and durable in children suffering from biliary dyskinesia. |
| Databáze: | OpenAIRE |
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