Al Talhi Yousef, Shirah Bader Hamza, Altowairqi Muteb, Yousef Yasmin
King Abdullah International Medical Research Centre, King Saud bin Abdulaziz University for Health Sciences, P.O. Box: 65362, Jeddah, 21556, Saudi Arabia.
Taif University, Taif, Saudi Arabia.
Clin J Gastroenterol. 2017 Aug;10(4):320-326. doi: 10.1007/s12328-017-0750-3. Epub 2017 May 29.
Patients with sickle cell disease (SCD) suffer from an increased incidence of gallstone formation due to hemolysis of sickled red blood cells; this leads to an increased level of bilirubin in secreted bile that becomes a nidus for pigment stone formation. Laparoscopic cholecystectomy (LC) is considered a standard operative procedure for gallstone disease mainly due to lower postoperative wound complaints, faster recovery, better postoperative cosmetic results, shorter hospital stay, and earlier return to work. Although numerous studies have been published addressing both the advantages and complications of LC in acute calcular cholecystitis, there is still limited evidence concerning the safety and efficacy of LC for the management of cholelithiasis in pediatric patients with SCD, and controversies remain unresolved. In this review, we aim to comprehensively study the available literature and propose evidence-based practice recommendations for the optimal management of gallstones in pediatric SCD patients. The current practice differs greatly depending on the prevalence of SCD in a particular geographic area. We acknowledge the limited number of patients reported, the lack of randomized control trials addressing the practice of specific recommendations, and the need for further evidence-based studies.
镰状细胞病（SCD）患者由于镰状红细胞的溶血作用，胆结石形成的发生率增加；这导致分泌胆汁中的胆红素水平升高，成为色素结石形成的病灶。腹腔镜胆囊切除术（LC）被认为是治疗胆结石疾病的标准手术方法，主要是因为术后伤口不适较少、恢复较快、术后美容效果较好、住院时间较短以及能更早重返工作岗位。尽管已经发表了许多关于LC在急性结石性胆囊炎中的优势和并发症的研究，但关于LC治疗小儿SCD患者胆石症的安全性和有效性的证据仍然有限，争议尚未解决。在本综述中，我们旨在全面研究现有文献，并为小儿SCD患者胆结石的最佳管理提出基于证据的实践建议。目前的做法因特定地理区域SCD的患病率不同而有很大差异。我们承认报告的患者数量有限，缺乏针对具体建议实践的随机对照试验，以及需要进一步的循证研究。
