CHOLECYSTECTOMY IN CHILDREN
Arynov NM, Shirtaev BK,
Kojabergenov AB
Syzganov Scientific Center
of Surgery, Almaty, Republic of Kazakhstan
The surgery of gall
bladder remains a problem in pediatric surgery. It is well known that, the
number of patients with cholecystitis and its complication is on the
increase. In our clinic from 1995 to year 2000 cholecystectomy was done to
36 children aged from 1year to 15 years old. The diagnostic evaluations
were: ultra sound scanning, computed tomography, endoscopic retrograde
pancreatocholangiography, cholecystocholangiography, etc. On this,
attention was given to organic and functional changes in biliary system,
and also efficacy of conservative treatment. Chronic cholelithiasis was
seen in 9 patients, chronic cholecystitis without stones was seen in
children with congenital and acquired lesion of the hepatobiliary systems
in 27 cases. In 20 cases the reasons of the chronic inflammatory process
was anomaly of the gall bladder and cystic ducticus, in 6 cases due to echinococcose
of the liver, 1 case due to gall bladder polyp. Laparoscopic
cholecystectomy was performed to 11 patients, 25 patients through
traditional laparotomy. Post operatively no complications or death
recorded. The patients were followed up post operatively from 1 month to 7
years and the results were good.
Therefore, the common
genesis of cholecystitis in children which requires surgical intervention
are pathologies of the biliary systems either congenital or acquired
pathology. Indication for surgery is its functional failure.