WOFAPS 2025 8th World Congress of Pediatric Surgery

Fares Chaabouni, Cyrine Saadi, Ahmed Ben Younes, Fatma Trabelsi, Asma Jabloun, Aida Daib, Rabiaa Ben Abdallah, Youssef Hellal

Paediatric Surgery Department, Hospital Habib Thameur, Tunis, Tunisia

Background:
Pediatric gallstone disease has become increasingly recognized due to improved imaging and rising risk factors such as obesity and hemolytic disorders. Laparoscopic cholecystectomy is now the standard surgical treatment. This study aims to evaluate the indications, operative outcomes, and postoperative course in a cohort of pediatric patients undergoing laparoscopic cholecystectomy.

Methods:
A retrospective review was conducted on children who underwent laparoscopic cholecystectomy between 2017 and 2024 in our pediatric surgery department.

Results:
Among the 95 patients, 50 were female (52.6%) and 45 were male (47.4%), with a mean age of 11.2 years (range: 4–17). The most common presenting symptoms were right upper quadrant pain (72%), nausea/vomiting (40%), and fever (18%). Underlying risk factors included obesity (31%), hemolytic anemia (14%), and familial predisposition (10%).

All procedures were completed laparoscopically. Intraoperative cholangiography was performed in 6 cases (6.3%) due to suspicion of common bile duct stones. No conversions to open surgery were necessary. Postoperative complications occurred in 6 patients (6.3%), including wound infection (n=2), bile leak (n=1), and transient ileus (n=3). The average hospital stay was 5.4 days.

Conclusion:
Laparoscopic cholecystectomy is a safe and effective approach for pediatric gallstone disease, with low morbidity and excellent recovery outcomes. Careful patient selection and management of underlying risk factors are essential to optimize results. Our experience supports its use as the standard treatment even in younger patients.