Laparoscopic or open cholecystectomy in patients with sickle cell disease:which approach is superior?

Objective: To compare laparoscopic with open cholecystectomy in patients wi th sickle cell disease. Design: Retrospective clinical study. Setting: University hospital, Greece. Subjects: 41 patients (22 men and 19 women) with sickle cell disease had la paroscopic cholecystectomy between September 1991 and June 1998. Each patie nt was matched for age, sex, year of operation, and number of preoperative transfusions with control patients with sickle cell disease who had open ch olecystectomy. Main outcome measures: Duration of operation, postoperative stay in hospita l, incidence of complications, and conversion to open operation. Results: The mean operation time was 81.4 min (range 55-125) for open chole cystectomy and 64.2 min (range 45-90) for laparoscopic cholecystectomy (p < 0.01). Complications occurred in 5% (2/41) of the patients in the laparosc opic group and in 20% (8/41) of the patients in the open group (p = 0.04). The mean length of stay in hospital was 5.6 days (range 3-9) in the open gr oup and 2.7 days (range 2-5) in the laparoscopic group (p < 0.01). Conversi on to open operation was necessary in 2 (5%) patients. Conclusions: Laparoscopic cholecystectomy resulted in a shorter hospital st ay with fewer postoperative complications than open operation in patients w ith sickle cell disease and may be the procedure of choice in the treatment of cholelithiasis in such patients.