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8- LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL DISEASE: IS IT A SAFE PROCEDURE?

Hashim S Alkhayat --- Jassim H Salim --- Mohammad M Mohammad --- Salim M Albassam

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2011 Volume: 17 Issue: 1 Pages: 54
Publisher: Basrah University جامعة البصرة

Abstract

Salim M Albassam*, Mohammad M Mohammad@, Jassim H Salim@&Hashim S Alkhayat@*Department of surgery, Basrah Medical College, Iraq. @Department of surgery, Basrah GeneralHospital, Iraq.Correspondence to: Dr. Salim M Albassam, e-mail: albassamsalim@yahoo.caAbbreviation: Hb= Hemoglobin. ACS = Acute Chest Syndrome. ASA = American Society of AnesthesiologistsAbstractThe aim of this trial is to determine the safety of laparoscopic cholecystectomy for treatment ofgall bladder stones in patients with sickle cell anemia (a controversial issue). Sixty patients fromboth sexes, between 19-35 years old with sickle cell anemia, all of them having gall bladderstones were included in this study in Endosurgery Center in Basrah General Hospital. Thepatients were divided into three groups, group one (19 patients) were selected for laparoscopiccholecystectomy on random preoperative background, the same thing was applied in group two(21 patients) whose patients were subjected to open cholecystectomy while patients in groupthree (20 patients) were selected for laparoscopic cholecystectomy on conditioned selection.Three mortalities and two serious morbidities were encountered in the group one and one mildmorbidity seen in group two and no mortalities or morbidities in group three. Laparoscopiccholecystectomy in sickle cell patients is a debatable issue, an increasing controversy aboutserious perioperative and postoperative morbidity were mentioned. The procedure itself wasaccused 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 surgeryand the adherence to the principle anesthetic rules on the outcome after laparoscopiccholecystectomy in patients with sickle cell disease. This influence was limited in openprocedure. The controversy in the different trials lies on wither the problem is confined to thedisease 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 diseaseand 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 generalanesthesia rules are mandatory for the safety of the patients.

Keywords

LAPAROSCOPIC --- CHOLECYSTECTOMY --- IN SICKLE