LAPAROSCOPIC CHOLECYSTECTOMY - TREATMENT OF CHOICE FOR CHOLELITHIASISIN CHILDREN

Laparoscopic cholecystectomy is rapidly replacing traditional cholecys tectomy as the standard treatment for cholelithiasis and cholecystitis in adults. Over a period of 16 months, 14 children with a clinical di agnosis of cholelithiasis, ranging in age from 4 to 15 years (mean 12. 2), were treated. All had symptoms of abdominal pain or vomiting; one had jaundice and recurrent cholecystitis. Five children (35%) had asso ciated metabolic or hemolytic diseases. The 14 children were operated on using the laparoscopic cholecystectomy technique. No operation was converted to open cholecystectomy, but two patients required laparotom y: one because of suspected injury to the common duct, and the other b ecause of nonvisualization of the gallbladder during laparoscopy. The mean postoperative hospital stay for the 11 children who underwent onl y laparoscopic cholecystectomy (one patient also had a simple mastecto my) was 50 hours (range 48-72 hours). All children resumed their norma l activities almost immediately after discharge from hospital. No long -term biliary or other complications were seen in any patient througho ut an average follow-up period of 6.2 months (range 3-16 months). The benefits of this operation in children are obvious: It is safe, effect ive, and well tolerated.