Rachid Sani, Didier Lassey James, Badé Mallam Abdou, Sani Chaibou Maman, Habibou Abarchi
Department of general and digestive surgery, National Hospital of Niamey PB: 238 Niamey- Niger.
Pan Afr Med J. 2009 Dec 6;3:19.
We report the results of our experience on laparoscopic cholecystectomy in sickle cell disease patients in Niger, which is included in the sickle cell belt.
A prospective study covering a period of 45 months, from July 2004 to March 2008. We included all sickle cell disease patients that underwent laparoscopic cholecystectomy. Blood transfusion was done for patients with haemoglobin (Hb) levels less than 9g/dl. Homozygous and composite heterozygous patients were admitted in intensive care unit for 24 hours or plus post operatively.
The series included 47 patients operated by the same surgeon, 31 females (66%) and 16 males (34%) (Ratio: 0.51). The average age was 22.4 years (range: 11 to 46 years) and eleven (23.4%) of them were aged less than 15 years. The types of sickle cell disease found were 37 SS, 2 SC, 1 S beta-thalassemia and 7 AS. Indications for surgery were biliary colic in 29 cases (61.7%) and acute cholecystitis in 18 cases (38.3%). The mean operative time was 64 min (range: 42 to 103 min). Conversion to open cholecystectomy in 2 cases (4.2 %) for non recognition of Calot's triangle structures. The postoperative complications were: four (4) cases of vaso-occlusive crisis and one case of acute chest syndrome. The mean postoperative hospital stay was 3,5days (range: 1 to 9 days). No mortality was encountered.
Laparoscopic cholecystectomy is a safe procedure in sickle cell patients. It should be a multidisciplinary approach and involve a haematologist, an anaesthesiologist and a surgeon.
我们报告了在位于镰状细胞高发地带的尼日尔，对镰状细胞病患者进行腹腔镜胆囊切除术的经验结果。
一项前瞻性研究，时间跨度为45个月，从2004年7月至2008年3月。纳入所有接受腹腔镜胆囊切除术的镰状细胞病患者。血红蛋白（Hb）水平低于9g/dl的患者进行输血。纯合子和复合杂合子患者术后在重症监护病房住院24小时或更长时间。
该系列包括由同一位外科医生手术的47例患者，其中女性31例（66%），男性16例（34%）（比例：0.51）。平均年龄为22.4岁（范围：11至46岁），其中11例（23.4%）年龄小于15岁。发现的镰状细胞病类型有37例SS型、2例SC型、1例Sβ地中海贫血型和7例AS型。手术指征为胆绞痛29例（61.7%），急性胆囊炎18例（38.3%）。平均手术时间为64分钟（范围：42至103分钟）。2例（4.2%）因未识别出胆囊三角结构而转为开腹胆囊切除术。术后并发症有：4例血管闭塞性危机和1例急性胸部综合征。术后平均住院时间为3.5天（范围：1至9天）。未发生死亡病例。
腹腔镜胆囊切除术对镰状细胞病患者是一种安全的手术。应采用多学科方法，涉及血液科医生、麻醉科医生和外科医生。
