INTRODUCTION: Cholecystectomy in children is not a common surgical procedure. In the past 5 years, we have performed it laparoscopically. There was no difference in insufflated pressure between 2 groups while no drainage catheter was placed.
OBJECTIVE: We present a modified laparoscopic technique in children.
METHODS: In a 5-year period, 54 children underwent laparoscopic cholecystectomy. Their ages ranged from 14 months to 15 years (mean: 7.6 years). Depending on the applied technique, the patients were separated into 2 groups. The first group comprised 17 patients on whom we performed the conventional 4-port technique. The second group comprised 37 patients on whom a modified technique was performed. We used 3 ports: an umbilical port for the camera, another in the subxifoid region for the dissector, and a third in the right lower quadrant for the grasping clamp and the extraction of the gallbladder. Vessel sealing electrocautery was used for ligation of the cystic artery and detachment of the gallbladder.
RESULTS: Reduction of the number of ports had no effect on accessibility and duration of the procedure; however, it simplified access and handling, particularly in the smaller patients. Conversion to open cholecystectomy was performed in 1 case with major deformities of the vertebral column. The duration of hospitalization varied from 1 to 4 days (mean: 2.7 days).
CONCLUSIONS: The decreased number of ports and the use of vessel sealing electrocautery make laparoscopic cholecystectomy in children easier and safe, without affecting the perioperative time.
Submitted by Evangelos Papandreou
- Copyright © 2008 by the American Academy of Pediatrics