Skip to main content
SpringerLink
Log in

Laparoscopic cholecystectomy in adults with sickle cell disease

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Chronic hemolysis predisposes adults with sickle cell disease (SCD) to the formation of bilirubinate cholelithiasis.

Methods

To study the impact of laparoscopic cholecystectomy (LC) on this groups, we reviewed our records of all patients with SCD and cholelithiasis treated electively from 1991 to 1999. During that period, 13 consecutive patients with SCD underwent elective LC for symptomatic cholelithiasis. Nine patients (69.2%) were managed with a preoperative transfusion regimen to achieve a hemoglobin value of ≥10 g/dl, independent of hemoglobin S percentage. Five patients who presented with jaundice were referred for preoperative endoscopic retrograde cholangiopancreatography (ERCP), which identified choledocholithiasis in two of them. Three other patients underwent intraoperative cholangiography, which revealed common bile duct stones in one patient.

Results

One patient developed pyrexia for 2 days. There were no vaso-occlusive crises or deaths. The mean hospital stay was 3.3 days.

Conclusions

LC has proven to be a safe and efficacious method for the treatment of symptomatic cholelithiasis in this high-risk population. Hematologists are now more willing to refer early, well-prepared patients with SCD and uncomplicated gallbladder disease for elective LC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Banerjee AK, Layton DM, Rennie JA, Bellingham AJ (1991) Safe surgery in sickle cell disease. Br J Surg 78: 516–517

    Article  PubMed  CAS  Google Scholar 

  2. Bentley PG, Howard ER (1979) Surgery in children with homozygous sickle cell anaemia. Ann R Coll Surg Engl 61: 55–58

    PubMed  CAS  Google Scholar 

  3. Bonatsos G, Leandros E, Dourakis N, Birbas C, Delibaltadakis G, Golematis B (1995) Laparoscopic cholecystectomy: intraoperative findings and postoperative complications. Surg Endosc 9: 889–893

    PubMed  CAS  Google Scholar 

  4. Bonatsos G, Leandros E, Polydorou A, Romanos A, Dourakis N, Birbas C, Golematis G (1996) ERCP in association with laparoscopic cholecystectomy: a strategy to minimize the number of unnecessary ERCPs. Surg Endosc 10: 37–40

    Article  PubMed  CAS  Google Scholar 

  5. Bond LR, Hatty SR, Hom MEC, Dick M, Meire HB, Bellingham AJ (1987) Gall stones in sickle call disease in the United Kingdom. Br Med J 295: 234

    Article  CAS  Google Scholar 

  6. Deliyannis GA, Tavlarakis (1995) Sickling phenomenon in northern Greece. Br Med J 2: 299–301

    Article  Google Scholar 

  7. Gholson CF, Grier JF, Ibach MB, Favrot D, Nall L, Sittig K, McDonald JC (1995) Sequential endoscopic/laparoscopic management of sickle hemoglobinopathy-associated cholelithiasis and suspected choledocholithiasis. South Med J 88: 1131–1135

    PubMed  CAS  Google Scholar 

  8. Huntington TR, LeMaster CB (1997) Laparoscopic hypothermia: heat loss from insufflation gas flow. Surg Laparosc Endosc 7: 153–155

    Article  PubMed  CAS  Google Scholar 

  9. Janik J, Seeler RA (1980) Perioperative management of children with sickle hemoglobinopathy. J Pediatr Surg 15: 117–120

    Article  PubMed  CAS  Google Scholar 

  10. Koshy M, Weiner SJ, Miller ST, Sleeper LA, Vichinsky E, Brown AK, Khkoo Y, Kinney TR., Co-operative Study of Sickle Cell Disease (1995) Surgery and anesthesia in sickle cell disease. Blood 86: 3676–3684

    PubMed  CAS  Google Scholar 

  11. Kudsk KA, Tranbaugh RF, Sheldon GF (1981) Acute surgical illness in patients with sickle cell anemia. Am J Surg 142: 113–117

    Article  PubMed  CAS  Google Scholar 

  12. Lukens JN (1993) The thalassemias and related disorders: quantitative disorders of hemoglobin synthesis. In: Lee CR, Bithell TC, Foerster J, Athens JW, Lukens JN (eds) Wintrobe’s clinical hematology. 9th ed. Lea and Febiger, Philadelphia, pp 1127

    Google Scholar 

  13. Meshikes AN, Al Dhurais SA, Al Jama AA, Al Faraj AA, Al Khatir NS, Al Abkar H (1995) Laparoscopic cholecystectomy in patients with sickle cell disease. J R Coll Surg Edinb 40: 383–385

    Google Scholar 

  14. Rutledge R, Croom RD, Davis JW, Berkowitz LR, Orringer EP (1986) Cholelithiasis in sickle cell anaemia: surgical considerations. South Med J 79: 28–30

    PubMed  CAS  Google Scholar 

  15. Sarnaik S (1980) Incidence of cholelithiasis in sickle cell anemia using the ultrasonic gray scale technique. J Pediatr 96: 1005–1008

    Article  PubMed  CAS  Google Scholar 

  16. Schubert TT (1986) Hepatobiliary system in sickle call disease. Gastroenterology 90: 2013–2021

    PubMed  CAS  Google Scholar 

  17. Serieant GR (1992) Distribution of sickle cell disease. In: Serjeant GR (ed) Sickle cell disease. 2nd ed. Oxford University Press, Oxford, pp 23

    Google Scholar 

  18. Stephens CG, Scott RB (1980) Cholelithiasis in sickle cell anemia: surgical or medical management. Arch Intern Med 140: 648–651

    Article  PubMed  CAS  Google Scholar 

  19. Tagge EP, Othersen HB, Jackson SM, Smith CD, Gayoso AJ, Abboud MR, Laver JL, Adams DB (1994) Impact of laparoscopic cholecystectomy on the management of cholelithiasis in children with sickle cell disease. J Pediatr Surg 29: 209–212

    Article  PubMed  CAS  Google Scholar 

  20. Vichinsky EP, Haberkern CM, Neumayr L, Earles AN, Black D, Koshy M, Pegelow C, Abboud M, Ohene-Frempong K, Iyer RV, The Preoperative Transfusion Study Group (1995) A comparison of conservative and aggressive transfusion regimens in the perioperative management of sickle cell disease. N Engl J Med 333: 206–213

    Article  PubMed  CAS  Google Scholar 

  21. Ware RY, Filston HC, Schultz WH, Kinney TR (1988) Elective cholecystectomy in children with sickle hemoglobinopathies: successful outcome using a preoperative transfusion regimen. Ann Surg 208: 17–22

    Article  PubMed  CAS  Google Scholar 

  22. Webb DK, Darby JS, Dunn DT, Terry SI, Serjeant GR (1989) Gallstones in Jamaican children with homozygous sickle cell disease. Arch Dis Child 64: 693–696

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Propaedeutic Surgery, Athens University, Hippokration Hospital, 114 Vas. Sofias Avenue, Athens, Greece

    G. Bonatsos, K. Birbas & K. Toutouzas

  2. Evgenidion Hospital, 20 Papadiamantopoulo Street, Athens, Greece

    G. Bonatsos, K. Birbas & K. Toutouzas

  3. TYPET Ygeias Melathron Hospital, 4 Thereianou Street, Athens, Greece

    G. Bonatsos & N. Durakis

Authors
  1. G. Bonatsos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Birbas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Toutouzas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Durakis
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Online publication: 14 May 2001

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonatsos, G., Birbas, K., Toutouzas, K. et al. Laparoscopic cholecystectomy in adults with sickle cell disease. Surg Endosc 15, 816–819 (2001). https://doi.org/10.1007/s004640000383

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004640000383

Keywords

Search

Navigation