Background and Aims As the preferred technique for cholecystectomy in children, we aim to review our experience with laparoscopic cholecystectomy in the pediatric population to better understand the associated complications and outcomes.
Methods We performed an IRB approved, retrospective chart review of children ≤ 18 years who underwent cholecystectomy at a single academic institution between the years 1990 and 2010.
Results 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%) of cases. Variations in anatomy and technical difficulties (e.g. presence of adhesions) were found in 45 (22.3%) of patients. Intraoperative cholangiogram was performed in 20 (9.9%) and concomitant splenectomy was undertaken in 16 (7.9%) cases. Only 8 (4%) of cases were converted to an open fashion, all due to a lack of anatomical clarity. There were zero common bile duct injuries; however spillage of bile was present in 12 (5.9%) patients. Postoperative complications including wound infection 4, retained stones 4, abdominal abscess 1, and biloma 0, totalled 9 patients (4.5%). Median operative time was 117.5 minutes. Median postoperative hospital stay was 1 day and 19 (9.4%) patients had recurrence of abdominal pain without associated pathology. Three patients (1.5%) required postoperative ERCP. In this cohort, average follow-up was 54 months.
Conclusion Laparoscopic cholecystectomy in pediatric population results in short postoperative hospital stays and has low complication rates. In our experience, it also leads to relatively high symptom relief.