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Laparoscopic cholecystectomy in children with sickle cell disease: A simple modified technique
Author(s) -
Al Hindi Saeed,
Al Aradi Husain,
Mubarak Mohamed
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12789
Subject(s) - medicine , gallstones , cholecystectomy , umbilicus (mollusc) , surgery , cosmesis , sickle cell anemia , disease , cholecystitis , gallbladder
Sickle cell disease and other hemoglobinopathies are prevalent in Bahrain. In our hospital, we often encounter children with gallstones; sometimes gallstones are discovered on routine abdominal ultrasound, and in other cases, patients present with symptoms. Elective cholecystectomy has been controversial in patients with sickle cell disease and cholelithiasis because surgery can be a challenge. Therefore, the aim of this study was to assess the safety of elective cholecystectomy in children with sickle cell disease with cholelithiasis, as well as the safety and efficacy of a simple modification to the conventional laparoscopic cholecystectomy technique using two natural creases in the skin. Methods The modified technique employs four ports, two of which were placed in natural crease lines, specifically the umbilicus and the groin crease. The procedure was elective for patients with sickle cell disease with gallstones. All patients received either a preoperative blood transfusion or an exchange transfusion to reduce the risk of postoperative sickle cell complications. Results Eighty‐one patients with sickle cell disease with gallstones underwent our simple modified laparoscopic cholecystectomy procedure. The mean ± SD operative time was 58.43 ± 8.02 minutes (range, 45‐80 minutes). Only eight patients (9.9%) experienced postoperative complications; six had fever, and two had a sickle cell crisis. None of the patients required conversion to open cholecystectomy or intensive care management. Conclusion Our simple modified laparoscopic cholecystectomy using two skin creases is a safe and feasible elective procedure in children with sickle cell disease that provides excellent cosmesis.