Laparoscopic cholecystectomy in 427 adults with sickle cell disease: a single-center experience

Abstract

Provided that standard perioperative care is ensured and the procedure is performed by experienced surgeons, LC in adults with SCD results in low rates of conversion and morbidity, no mortality, and a short hospital stay.

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

“…The role for antibioprophylaxis is discussed by many, and two strategies seem to co‐exist in the literature. There are authors recommending prophylaxis according to type of surgery, and others adapting it to the individual patients' medical histories . As a standout, splenectomy needs specific considerations, including preoperative immunizations against encapsulated bacteria, as in the context of asplenia .…”

“…Thrombophilia evaluation is suggested, in some reviews . Preoperative preparation occasionally includes chest physiotherapy and intra‐venous hydration during the fasting period . Bicarbonate treatment, as a prevention to acidosis, has been reported as a standard treatment in older manuscripts .…”

“…Regarding thresholds, earlier recommendations advocate “no transfusion” prior to surgery or minor risk surgeries, as long as the hemoglobin level was >4 to 5 g/dL . This limit had the tendency to move upwards with time, many authors currently recommending a hemoglobin level ≥9‐10 g/dL, before minor to intermediate risk surgery, whilst some groups still advocate 7 g/dL . A hemoglobin threshold of >10 g/dL is considered by some authors as a target for major surgeries .…”

Epidural anesthesia for laparoscopic cholecystectomy in a patient with sickle cell anemia, beta thalassemia, and Crohn's disease -A case report-

“…Epidural anesthesia, no special postoperative complications, may be applicable for LC. However, the incidence of intraoperative referred shoulder pain is high, and so careful patient recruitment and management of shoulder pain should be considered [2,4,5]. Thus we decided that our patient with sickle cell anemia, beta (+) thalassemia, and Crohn's disease, who demonstrated liver dysfunction would undergo anesthetic management using the thoracic epidural anesthesia (TEA) technique.…”

Detection and management of bile duct stones

“…7,8 When assessed by intraoperative cholangiography, stone migration from the gallbladder to the bile duct is a frequent event. The prevalence of BDSs in patients undergoing cholecystectomy for symptomatic gallstones varies from 4% to 20% of all cases.…”