Urgent laparoscopic cholecystectomy as a result of acute calculous cholecystitis in Pediatrics.

J Jiménez Gómez, P Jiménez Arribas, J Betancourth Alvarenga, S Santiago Martínez, B San Vicente Vela, M Gaspar Pérez, J Roberto Güizzo, C Esteva Miró, B Sánchez Vázquez, N Álvarez García, B Núñez García
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Abstract

Introduction: In spite of the increase in the prevalence of cholelithiasis in the last decades, no recommendations regarding the best treatment of acute calculous cholecystitis (AC) in Pediatrics have been developed.

Clinical case: 4-year-old, 20kg male patient with no significant history referred to our institution as a result of abdominal sepsis. The blood count showed leukocytosis, with normal hemoglobin and bilirubin levels, and a normal liver function. The abdominal ultrasonography revealed cholelithiasis, gallbladder hydrops, and an inflammatory process compatible with appendicular plastron. In the diagnostic laparoscopy, the appendix was macroscopically normal, and acute cholecystitis was observed. Given the patient's situation, and in cooperation with the General Surgery Department, laparoscopic cholecystectomy was carried out. The patient recovered uneventfully on hospitalization day 5 under piperacillin-tazobactam treatment.

Discussion: There are no recommendations regarding AC treatment in children. In septic patients, cooperation between general and pediatric surgeons allows urgent cholecystectomy to be considered as a safe option.

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儿科急性结石性胆囊炎的急诊腹腔镜胆囊切除术。
引言:尽管在过去的几十年里,胆结石的患病率有所上升,但在儿科学中,还没有关于急性结石性胆囊炎(AC)的最佳治疗方法的建议。临床病例:4岁,20公斤男性患者,无重大病史,因腹部败血症转诊至我院。血细胞计数显示白细胞增多,血红蛋白和胆红素水平正常,肝功能正常。腹部超声检查显示胆囊结石、胆囊积水和与阑尾质体相容的炎症过程。在诊断性腹腔镜检查中,阑尾宏观正常,观察到急性胆囊炎。考虑到患者的情况,在普通外科的合作下,进行了腹腔镜胆囊切除术。患者在住院第5天接受哌拉西林-他唑巴坦治疗后顺利康复。讨论:没有关于儿童AC治疗的建议。在败血症患者中,普通外科医生和儿科外科医生之间的合作使紧急胆囊切除术被认为是一种安全的选择。
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