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Abstract

ABSTRACT: BACKGROUND: Gallstones in children are rare but can become a potentially serious condition [1,2]. Symptomatic cholelithiasis that is requiring surgery in children has been increased in tendency over the last 10 years. The incidence of cholelithiasis in children ranges from 0.13 to 1.9 % and when compared with the adult population , the risk of cholelithiasis incidence is assessed to be as 10–15 % . The experience of pediatric surgical centers is estimated to be very scarce (3,4) . Contemporary Laparoscopic Cholecystectomy is considered as the gold standard procedure in the management of gallbladder diseases in both adults and children . Children that are considered to be a candidates for surgery should be operated in pediatric surgery clinics experienced in minimally invasive techniques (3) . OBJECTIVE: Pediatric laparoscopic cholecystectomy has not been evaluated in Iraq , here is an evaluation of the procedure for 29 cases is presented mainly to study its application in this group of patients. PATIENTS AND METHODS: This is a preliminary study of 29 cases of pediatric laparoscopic cholecystectomy performed in Erbil city in the period from 2011 to 2017. Age range was 5 months -11 years, 21 males & 8 females . Three of them were obese & one overweight . Both , three millimeter & 5 mm ports were used , 4 ports were inserted . RESULTS: Out of 29 cases, 21 (72.42 %) were males & 8 (27.58 %) were females, ranging from 5 months – 11 yrs . Twenty – five of the cases were electively operated on . Oral feeding started after 6 hrs , patients were discharged after 8 hrs except two patients who stayed for 36 hrs , mean hospital stay was 13 hrs and 42 min . The mean operative time was 31 min (range from 20 min to 60 min) . The was laparoscopic cholecystectomy performed by single specialist pediatric surgeon. All cases were done as day case surgery except for the emergency cases. The time of hospitalization ranged from 8 hrs to 3 days. There were no intra operative complications that require reoperation such as injury to the common bile duct or other viscera, bile leakage or vascular injury. CONCLUSION: Laparoscopic surgery is a safe procedure in children for excising the gall bladder . Age of the patient is not a contraindication to operation , and LC may be performed even in young children with symptomatic gall bladder disease with low morbidity . it should therefore be considered as the procedure of choice in pediatric patients (10,11) .

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