Laparoscopic gallbladder surgery safe for kids

Laparoscopic removal of the gallbladder in children doesn’t injure the bile duct; has low complication rates; and results in short hospital stays, a study from the Mayo Clinic has found.

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A retrospective chart review of children aged younger than 18 years who underwent cholecystectomy between 1990 and 2010 found that 202 of 325 surgeries were performed laparoscopically, primarily for symptomatic gallstones. Median operative time was 117.5 minutes, and median postoperative hospital stay was 1 day.

Laparoscopy caused no injuries to the common bile duct, although spillage of bile occurred in 12 patients (5.9%). Nine patients (4.5%) suffered postop complications, including wound infection, retained stones, abdominal abscess, and biloma; abdominal pain recurred in 19 (9.4%) but was unrelated to gallstones or gallbladder disease.

The researchers concluded that laparoscopic cholecystectomy is a safe procedure for children. The Mayo Clinic now performs all laparoscopic gallbladder surgeries using a single small incision through the belly button rather than the standard 4 abdominal incisions.

Although children are less likely than adults to get gallstones and other gallbladder diseases, pediatric prevalence has been increasing in tandem with rising rates of obesity in children, motivating the researchers to review surgical techniques in this age group.

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