8- LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL DISEASE: IS IT A SAFE PROCEDURE?
Basrah Journal of Surgery,
Volume 17, Issue 1, Pages 0-0
AbstractSalim M Albassam*, Mohammad M Mohammad@, Jassim H Salim@&
Hashim S Alkhayat@
*Department of surgery, Basrah Medical College, Iraq. @Department of surgery, Basrah General
Correspondence to: Dr. Salim M Albassam, e-mail: email@example.com
Abbreviation: Hb= Hemoglobin. ACS = Acute Chest Syndrome. ASA = American Society of Anesthesiologists
The aim of this trial is to determine the safety of laparoscopic cholecystectomy for treatment of
gall bladder stones in patients with sickle cell anemia (a controversial issue). Sixty patients from
both sexes, between 19-35 years old with sickle cell anemia, all of them having gall bladder
stones were included in this study in Endosurgery Center in Basrah General Hospital. The
patients were divided into three groups, group one (19 patients) were selected for laparoscopic
cholecystectomy on random preoperative background, the same thing was applied in group two
(21 patients) whose patients were subjected to open cholecystectomy while patients in group
three (20 patients) were selected for laparoscopic cholecystectomy on conditioned selection.
Three mortalities and two serious morbidities were encountered in the group one and one mild
morbidity seen in group two and no mortalities or morbidities in group three. Laparoscopic
cholecystectomy in sickle cell patients is a debatable issue, an increasing controversy about
serious perioperative and postoperative morbidity were mentioned. The procedure itself was
accused and an entirely opposed results were emerged from different studies all are debatable.
In this study we noticed the big influence of the risk factors, preparation of patients for surgery
and the adherence to the principle anesthetic rules on the outcome after laparoscopic
cholecystectomy in patients with sickle cell disease. This influence was limited in open
procedure. The controversy in the different trials lies on wither the problem is confined to the
disease itself or to the surgical method used for cholecystectomy or both.
According to the results obtained from our study we believe that both the severity of the disease
and the surgical procedure affecting the results, application of intra and post operative protocol
(blood transfusion if Hb less than 9gm/dI, rehydration, oxygenation and respecting general
anesthesia rules are mandatory for the safety of the patients.
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