Laparoscopic Cholecystectomy in Children: Is It Better than Open Surgery?

Abstract

Background and Purpose

: Laparoscopic cholecystectomy was first described in children less than 10 years ago, and since then, it has been shown to be feasible and safe. However, it has never been demonstrated that laparoscopic cholecystectomy is more advantageous than the open technique in children. The purpose of this study was to determine whether laparoscopic cholecystectomy was more beneficial than open surgery in the pediatric population.

Patients and Methods

: A case-control review of all patients age less than 19 years who underwent either laparoscopic (N = 20) or open (N = 20) cholecystectomy for gallstone disease from 1991 to 1996 was performed.

Results

: Compared with the open cholecystectomy group, patients who underwent laparoscopic cholecystectomy had a longer mean operative time (125 v 83 minutes), had less blood loss (25 v 32 mL), resumed oral intake sooner (same day v postoperative day 1), required less postoperative analgesia (morphine 0.7 mg/kg v 1.5 mg/kg), and were discharged sooner (postoperative day 3 v postoperative day 5). There was one surgical complication in the laparoscopic group and none in the open group.

Conclusion

: Although laparoscopic cholecystectomy takes longer than open cholecystectomy, it results in less postoperative narcotic use and a shorter hospital stay. It appears that children enjoy the same benefits of laparoscopic cholecystectomy as do adults.