2009, Number 1
Colecistectomía Laparoscopica in Age Pediatrica: Experience at a Hospital in Third Level
Olvera-Durán JÁ, Mora-Rico K, Romero-Montes VE, Reyes-Villagómez JF, Clementina-de Paredes SL, Lucas-Rodríguez R
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Language: Spanish
References: 17
Page: 20-24
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ABSTRACT
Introduction: cholelithiasis is a pathology own adulthood, little is known about the epidemiology in the group pediatric, reported a prevalence around 5 per cent in this age group. In pediatrics,the laparoscopic cholecystectomy was carried out since 1971 by Gans. The increase in the suspicion diagnosed and progress in the technology allows better results in the diagnosis and treatment.Material and Methods: Were revised the clinical histories of patients younger than 18 years operated cholecystectomy in a hospital in third level of January 1995 to December 2007.The variables studied were age, gender, diagnosis, collision of the surgery, diagnostic studies, surgical time, occlusion techniques, the artery and cystic duct, complications transoperatorias and postoperative complications. Without making any procedure concomitant with the surgery.
Results: The population consisted of 42 children, 5 men (11.9%) and 37 women (88.1%). With an average age of 12 years. Being the indications cholelithiasis 83.3 per cent and Acute cholecystitis alitiásica 16.7%; all showed clinical data of cholecystitis and the diagnosis was confirmed by ultrasound.
The surgical procedure consisted in laparoscopic cholecystectomy and the blockage of the artery and cystic duct was with ligation stitched in 18 patients (42.8%), staples of titanium in 4 (9.5%) and hydrolysis knife harmoniously in 20 patients (47.6%). The average time testing was 57 minutes, with a conversion rate of 2.3% (patients) and the complication operation more common was the bleeding (two patients). After the surgery all patients were asymptomatic, with a hospital stay of 2.6 days and discharged. No patient presenting complications post.
Conclusions: The laparoscopic cholecystectomy proves to be a procedure safe and effective with minimal morbidity, is the technique of choice for the management of cholelithiasis in pediatric patients. It noted that the method of blockage of the artery and cystic duct hydrolysis knife harmonious is a safe technique without complications. By the foregoing propose the handling of the way bile and vascular with scalpel harmonious.
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