RESUMO
BACKGROUND: We undertook this study to evaluate the results of surgical treatment of symptomatic cholelithiasis through laparoscopic cholecystectomy in a series of 47 consecutive pediatric patients. METHODS: During a 5-year period (2001-2005) we performed laparoscopic cholecystectomy in 47 patients <18 years old in one institution by the same surgical team. The population was comprised of 41 girls and 6 boys (age range: 6-18 years). All had symptomatic cholelithiasis confirmed at ultrasound examination. Associated pathology was studied in each case. The surgical procedure consisted of a four-port laparoscopic cholecystectomy under CO(2) pneumoperitoneum. No other concomitant procedure was performed in any case. RESULTS: Median age was 14.6 years old. The youngest patient of the series had a hematological disease. In girls we identified obesity in 62.5% of patients, with a body mass index (BMI) of 26.6 kg/m(2) (SD 3.0) vs. 21.5 kg/m(2) (SD 3.0) in boys (p <0.05), 30% of the girls had a positive medical history for pregnancies (range 1-3) and 15% regularly used oral contraceptives. All cases were symptomatic and 13% suffered from acute biliary pancreatitis. Average surgical time was 59.8 min, the conversion rate was 2.1% and the most frequent surgical complication was gallbladder rupture. No major morbidity was observed as well as no mortality. Postoperatively, all patients were asymptomatic, with a minimum follow-up time of 6 months. CONCLUSIONS: Laparoscopic cholecystectomy was highly effective in cases of symptomatic cholelithiasis. Etiologically, females showed risk factors for cholelithiasis similar to those usually observed in adults. Probably in the near future the incidence of cholelithiasis will increase in this age group. Pediatric surgeons should be familiarized with the minimal access technique to treat this disease.