Does cholecystectomy in patients with sickle cell disease reduce vaso-occlusive crises? A study conducted in two referral hospitals in Niger.

UNLABELLED: The objective of this study was to report on the results of cholecystectomy in patients with sickle cell disease in two hospitals in Niger.

PATIENTS AND

METHODS

This was a retrospective study conducted over a six-year period in the general referral hospital and the national hospital of Niamey (Niger).

RESULTS

We collected data concerning 56 cases of cholecystectomy in patients with sickle cell disease, representing of 10.3% of all cholecystectomies (gall bladder removals) performed. A majority of the patients were female (55.4%), with a mean age of 20.2 years, standard deviation of 8.8, and extreme values at 6 and 47 years. Homozygous SS forms of sickle cell disease predominated (92.9%). Nearly two-thirds of the patients (64.3%) were referred from the national sickle cell disease referral center. The main operative indication (69.6%) was symptomatic gall bladder (vesicular) lithiasis. All of the patients were anemic, with severe anemia in nearly half (44.6%). Exchange transfusion was carried out in 42.9% of the patients, and perioperative blood transfusion in 57.1%. The laparoscopic route was followed in almost all of the patients (94.6%). Mean postoperative stay in an intensive care unit was 23.5±7.2 (12-48) 48hours. The rate of postoperative complications was 23.2%, and the rate of mortality was 1.8%. As regards disease progress at one year, no vaso-occlusive crises were observed in seven eight (87.5) of the patients.

CONCLUSION

Cholecystectomy in sickle cell patients calls for a multidisciplinary strategy, and laparoscopy appears to be the ideal approach, especially insofar as it provides satisfactory postoperative comfort.