Prophylactic cholecystectomy by low-impact laparoscopy in drepanocyte children after selective transfusion exchange: the result of a monocentric study

Background: A monocentric study was undertaken in order to study the morbidity of cholecystectomy by low-impact laparoscopy in sickle cell children with asymptomatic vesicular lithiasis, and to bring the relevance of a clinical pathway with selective preoperative transfusion exchange in the prevention of alloimmunization. Method: Over a period of 7 years, between July 2011 and August 2018, 44 consecutive sickle cell children were surgically treated for their cholelithiasis. During the first phase of the study, 22 children had a systematic transfusion exchange. For the next 22 children, from January 2016, a selective transfusion exchange protocol was applied. Results: Microcœlioscopy was converted into laparoscopy. No perioperative complication occurred in patients after a transfusion exchange. The selective exchange protocol reduced the number of transfusions by 77.28 %. Acute thoracic crisis occurred on day 1 in one of the non-transfused patients requiring postoperative transfusion. Conclusion: A transfusion exchange was performed selectively. Only laparoscopic cholecystectomy was performed under general anesthesia. Acute thoracic crisis occurred on day 1 in one of the non-transfused patients requiring postoperative transfusion.