LAPAROSCOPIC VERSUS OPEN CHOLECYSTECTOMY IN CHILDREN

Twenty-one consecutive laparoscopic cholecystectomies (LC) were compar ed with 29 consecutive open cholecystectomies (OC). Sickle-cell diseas e (SCD) was the most common reason for cholecystectomy in both groups. The average length of operative time for LC was significantly longer than that of OC (P = 0.0149). In 1 patient there was conversion from L C to OC due to severe adhesions. Common bile duct (CBD) stones were di agnosed in 8 (27.6%) of the OC group; in 4 of them the diagnosis was m ade preoperatively by ultrasound, in 4 by intraoperative cholangiogram . All 8 patients required CBD exploration, and 2 had additional transd uodenal sphincteroplasties. In the LC group 5 patients (23.8%) had CBD stones. All had (ERCP) endoscopic retrograde cholangiopancreatography sphincterotomy, and stone extraction followed by LC. ERCP is a necess ary adjunct to treatment if LC is to be contemplated. Six patients in the OC group developed complications, while only 4 patients in the LC group developed minor complications. The length of hospitalization aft er LC was significantly shorter than after OC (P = 0.0150). LC is the procedure of choice in the management of cholelithiasis in children, e specially those with SCD.