فهرست نشریات علمی دسترسی آزاد ایران

AbstractPurposeThis study introduces a compelling alternative to traditional pediatric laparoscopic cholecystectomy.MethodWe conducted a three-year prospective study from 2020 to 2022 in two different centers. This preliminary descriptive and analytic study included a randomized trial and statistical analysis to determine whether Minimally Invasive Open Cholecystectomy (MIOC) is comparable to laparoscopic surgery, using the Pearson coefficient test with significance set at better than 1%. Children were randomly selected and the “open” cholecystectomy was performed by the same pediatric surgeon for all cases. We conducted tracking and tracing to identify the gallbladder's projection on the abdominal skin. Our surgical procedure involved tracking and tracing to identify the gallbladder’s projection on the abdominal skin, followed by retrograde dissection towards gallbladder’s neck, with cholecystectomy either anterograde or retrograde.ResultsTwenty-seven children aged from zero to fifteen were recorded (19 cases at ARCH and 8 cases at IPGH) among 1,965 treated in the two departments during the study, resulting in an incidence rate of 0.0137. The average age of the children was three years, with a range from eighteen months to eleven years. The most represented age group was six to eight years old. Our series included 15 boys and 12 girls, giving a sex ratio of 1.25. The most common reason for surgery was cholelithiasis, accounting for 74.1% of the cases. The mean operating time was 65 minutes (range 50-92 minutes), and celiotomy length varied from 20 to 28 mm. Anterograde cholecystectomy was performed in 92.6% of cases, with bile drainage needed in two patients (7%). The median follow-up period was 24 months, and all patients experienced good postoperative results. The minor complications were infection and jaundice. The average length of hospital stay was 3 days (range 2-6 days). There was a positive correlation between cosmetic and functional outcomes for open surgery (P=0.3). Conclusion : the authors present an effective minimally invasive open cholecystectomy.Keywords: Minimally invasive surgery; Pediatric mini-laparotomy; Cholelithiasis; Cholecystectomy.