Incidental appendectomy during laparoscopic cholecystectomy in children with sickle cell disease and symptomatic gallstones retrospective comparative case-control study

ABSTRACT

Laparoscopic cholecystectomy [LC] has become a standard treatment for symptomatic gall stones in children and adolescents with sickle cell disease. Incidental appendectomy has been advocated during LC in order to avoid the diagnostic dilemma of differentiating surgical and medical causes of abdominal pain in this group of patients. To evaluate the impact of this proposal on the outcome of surgery; a 10 years retrospective case- control review was conducted on 106 sicklers below age of 18 years who underwent LC with or without appendectomy in the Eastern province of Saudi Arabia. The patients were divided into two groups; group I [LCA], included cases who had laparoscopic incidental appendectomy during cholecystectomy [51 cases] and group II [LC] included those who had laparoscopic cholecystectomy only [55 cases]. The groups were compared regarding the demographic and clinical patients data, operative time, conversion rate, postoperative morbidity and mortality, hospital stay and overall long term outcome. Seven out of the 106 cases were converted to open procedure [6.6%]. These cases had relatively higher morbidity [20 7%], mortality [1.8%.] and longer hospital stay [5.5 +/- 3.9] days. Other than the longer operative time in the LCA group, there was no statistical or clinical significant difference between the two groups regarding the short or long term outcome. When technically feasible, incidental appendectomy is recommended during laparoscopic cholecystectomy for.sicklers with gall stones and recurrent abdominal pain