Laparoscopic cholecystectomy in children: A systematic review and meta-analysis |
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| Institution: | 1. St. George''s University Hospital, Blackshaw Road Tooting, London, SW17 0QT, United Kingdom;2. University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom;3. Royal Devon and Exeter Hospital, Barrack Road, EX2 5DW, Exeter, United Kingdom;4. Dept of Paediatric Surgery, AIIMS, Raipur, India;1. Children''s University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland;2. Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland;3. UCD School of Medicine, University College Dublin, Belfield, Dublin 4 Ireland;1. Department of Pharmacy, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY, 11201, USA;2. Department of Pharmacy, St. Joseph''s University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA;3. Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA;4. Department of Surgery – Trauma Division, St. Joseph''s University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA;5. Department of Mathematical Sciences, New Jersey Institute of Technology, 323 Dr Martin Luther King Jr Blvd, Newark, NJ, 07102, USA;1. Breast Surgery, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom;2. Breast Surgery, Royal Hampshire County Hospital, Hampshire, United Kingdom;3. The Nightingale Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom;4. Breast Surgery, Glenfield Hospital, Groby Road, Leicester, United Kingdom;5. Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom;1. Department of General Surgery, Beijing Children''s Hospital, Capital Medical University, National Center for Children''s Health, No.56 Nanlishi St, Beijing 100045, China;2. Department of Pediatric Surgery, Qilu Hospital of Shandong University, No. 107 West Wenhua St, Jinan, Shandong 250000, China;3. Shanghai Medical College, Fudan University, No. 138 Yixueyuan St, Shanghai 200032, China;1. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran;2. Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran;3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran;4. Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;5. Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran |
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| Abstract: | BackgroundLaparoscopic cholecystectomy (LC) has become the procedure of choice for the removal of gallbladder within the paediatric population. The aim of this study was to perform a systematic review and meta-analysis of the literature spanning the last 20 years to understand the indications for and safety of LCs in children.MethodsA comprehensive search of the published English language literature from January 2000 to June 2020 was done on PubMed, MEDLINE, and Google Scholar.ResultsIn total, 76,524 LC cases were identified from 114 studies. 78.9% of the patients were female and average age was 12 years old. Associated haematological disorders were identified in 16% of cases. The commonest indication for LC was cholelithiasis (68.4% in 66 studies), followed by cholecystitis (59.2% in 53 studies). Median operating time was 77 min. Median hospital stay was 2 days. The overall postoperative complication rate was 3.4% Major complications included bile duct injury (0.4%) and intra- or post-operative bleeding (0.9%). The conversion rate to open procedure was 2%. When comparing post-operative outcomes between emergency and elective admissions, three papers lent themselves to meta-analysis demonstrating no significant difference (p = 0.42). There was no statistically significant difference in postoperative complication rate between “hot” and “cold” laparoscopic cholecystectomies (p = 0.6).ConclusionThis systematic review and meta-analysis is the largest collection of subjects on laparoscopic cholecystectomies in children. Laparoscopic cholecystectomy is a safe operation in children, with complication rates similar or comparable to the adult literature. Cholelithiasis, cholecystitis and biliary dyskinesia were the commonest indications for LC. |
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| Keywords: | Laparoscopic Cholecystectomy Children Pediatric Safety |
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